Comparison of a multitarget blood test to ultrasound and alpha‐fetoprotein for hepatocellular carcinoma surveillance: Results of a network meta‐analysis DOI Creative Commons
Amit G. Singal, Benjamin Haaland, Neehar D. Parikh

et al.

Hepatology Communications, Journal Year: 2022, Volume and Issue: 6(10), P. 2925 - 2936

Published: Aug. 9, 2022

Ultrasound-based surveillance has suboptimal sensitivity for early detection of hepatocellular carcinoma (HCC) in patients with cirrhosis. There are several emerging alternatives, including a novel multitarget HCC blood test (Mt-HBT). We compared performance mt-HBT against ultrasound or without alpha-fetoprotein (AFP) Per the Preferred Reporting Items Systematic Reviews and Meta-Analysis (PRISMA) guidelines, two reviewers searched PubMed, Cochrane, Embase, clinicaltrials.gov databases from January 1990 through December 2020 to identify studies reporting and/or specificity AFP overall stage Mt-HBT diagnostic was derived clinical validation study. A network meta-analysis model built comparative assessment, pooled estimates at fixed were estimated based on Bayesian binormal receiver operating characteristic models each modality. Forty-one (comprising 62,517 cirrhosis) met inclusion criteria. Ultrasound-alone 51.6% (95% credible interval [CrI], 43.3%-60.5%) detection, which increased addition 74.1% CrI, 62.6%-82.4%); however, this offset by decreased (87.9% vs. 83.9%, respectively). With 90%, higher than alone (18.2%; 95% 0.2%-37.7%) similar (-3.3%; -22.3%-17.4%). Pairwise posterior probabilities suggested preference over 97.4% cases but only 36.3% versus AFP. Conclusion: blood-based could be comparable alternative existing methods who risk.

Language: Английский

AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma DOI Open Access
Amit G. Singal, Josep M. Llovet, Mark Yarchoan

et al.

Hepatology, Journal Year: 2023, Volume and Issue: 78(6), P. 1922 - 1965

Published: May 18, 2023

Singal, Amit G.; Llovet, Josep M.; Yarchoan, Mark; Mehta, Neil; Heimbach, Julie K.; Dawson, Laura A.; Jou, Janice H.; Kulik, Agopian, Vatche Marrero, Jorge Mendiratta-Lala, Mishal; Brown, Daniel B.; Rilling, William S.; Goyal, Lipika; Wei, Alice C.; Taddei, Tamar H. Author Information

Language: Английский

Citations

734
Global trends in hepatocellular carcinoma epidemiology: implications for screening, prevention and therapy DOI
Amit G. Singal, Fasiha Kanwal, Josep M. Llovet

et al.

Nature Reviews Clinical Oncology, Journal Year: 2023, Volume and Issue: 20(12), P. 864 - 884

Published: Oct. 26, 2023

Language: Английский

Citations

324
Blood-based biomarkers for hepatocellular carcinoma screening: Approaching the end of the ultrasound era? DOI Creative Commons
Neehar D. Parikh, Nabihah Tayob, Amit G. Singal

et al.

Journal of Hepatology, Journal Year: 2022, Volume and Issue: 78(1), P. 207 - 216

Published: Sept. 8, 2022

Language: Английский

Citations

104
Detecting Liver Cancer Using Cell-Free DNA Fragmentomes DOI Creative Commons
Zachariah H. Foda, Akshaya V. Annapragada, Kavya Boyapati

et al.

Cancer Discovery, Journal Year: 2022, Volume and Issue: 13(3), P. 616 - 631

Published: Nov. 18, 2022

Abstract Liver cancer is a major cause of mortality worldwide. Screening individuals at high risk, including those with cirrhosis and viral hepatitis, provides an avenue for improved survival, but current screening methods are inadequate. In this study, we used whole-genome cell-free DNA (cfDNA) fragmentome analyses to evaluate 724 from the United States, European Union, or Hong Kong hepatocellular carcinoma (HCC) who were average high-risk HCC. Using machine learning model that incorporated multifeature data, sensitivity detecting was 88% in average-risk population 98% specificity 85% among 80% specificity. We validated these results independent population. cfDNA fragmentation changes reflected genomic chromatin liver cancer, transcription factor binding sites. These findings provide biological basis patients accessible approach noninvasive detection. Significance: There great need sensitive approaches HCC have developed examining genome-wide features high-performing cost-effective See related commentary Rolfo Russo, p. 532. This article highlighted Issue feature, 517

Language: Английский

Citations

103
Hepatocellular carcinoma surveillance — utilization, barriers and the impact of changing aetiology DOI
Daniel Q. Huang, Amit G. Singal, Fasiha Kanwal

et al.

Nature Reviews Gastroenterology & Hepatology, Journal Year: 2023, Volume and Issue: 20(12), P. 797 - 809

Published: Aug. 3, 2023

Language: Английский

Citations

86
Battle of the biopsies: Role of tissue and liquid biopsy in hepatocellular carcinoma DOI Creative Commons
Brandon M. Lehrich, Josephine Zhang, Satdarshan P. Monga

et al.

Journal of Hepatology, Journal Year: 2023, Volume and Issue: 80(3), P. 515 - 530

Published: Dec. 15, 2023

The diagnosis and management of hepatocellular carcinoma (HCC) have improved significantly in recent years. With the introduction immunotherapy-based combination therapy, there has been a notable expansion treatment options for patients with unresectable HCC. Simultaneously, innovative molecular tests early detection HCC are emerging. This progress prompts key question: as liquid biopsy techniques rise prominence, will they replace traditional tissue biopsies, or both remain relevant? Given ongoing challenges detection, including issues ultrasound sensitivity, accessibility, patient adherence to surveillance, evolution diagnostic is more relevant than ever. Furthermore, accurate stratification limited by absence reliable biomarkers which can predict response therapies. While advantages diagnostics evident, their potential not yet fully harnessed, largely because biopsies routinely performed Liquid analysing components such circulating tumour cells, DNA, extracellular vesicles, provide promising alternative, though still associated related cost, accessibility. results from multi-analyte panels suggest could play transformative role management; however, comprehensive clinical validation ongoing. In this review, we explore biopsy, highlighting that these methods, while distinct approaches, set jointly reshape future management.

Language: Английский

Citations

47
Alpha-fetoprotein: Past, present, and future DOI Creative Commons
Yee Hui Yeo, Yi‐Te Lee, Hsian‐Rong Tseng

et al.

Hepatology Communications, Journal Year: 2024, Volume and Issue: 8(5)

Published: April 12, 2024

Alpha-fetoprotein (AFP) is a glycoprotein that plays an important role in immune regulation with critical involvement early human development and maintaining the balance during pregnancy. Postfetal development, regulatory mechanisms controlling AFP undergo shift gene transcription suppressed. Instead, these enhancers refocus their activity to maintain albumin throughout adulthood. During postnatal period, expression can increase setting of hepatocyte injury, regeneration, malignant transformation. It first oncoprotein discovered routinely used as part screening strategy for HCC. has been shown be powerful prognostic biomarker, multiple HCC prognosis models confirmed independent utility AFP. also useful predictive biomarker monitoring treatment response In addition its roles modulation promote tumorigenesis thus investigated therapeutic target this review article, we aim provide overview AFP, encompassing discovery, biological role, combination other biomarkers how it impacts clinical practice future direction.

Language: Английский

Citations

22
British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults DOI Creative Commons
Abid Suddle, Helen L. Reeves, Richard Hubner

et al.

Gut, Journal Year: 2024, Volume and Issue: 73(8), P. 1235 - 1268

Published: April 16, 2024

Deaths from the majority of cancers are falling globally, but incidence and mortality hepatocellular carcinoma (HCC) is increasing in United Kingdom other Western countries. HCC a highly fatal cancer, often diagnosed late, with an to ratio that approaches 1. Despite there being number treatment options, including those associated good medium long-term survival, 5-year survival UK remains below 20%. Sex, ethnicity deprivation important demographics for of, and/or from, HCC. These clinical practice guidelines will provide evidence-based advice assessment management patients The scientific data underpinning recommendations we make summarised detail. Much content have broad relevance, algorithms based on therapies available regulatory approval use National Health Service.

Language: Английский

Citations

18
Risk stratification and early detection biomarkers for precision HCC screening DOI
Yi‐Te Lee, Naoto Fujiwara, Ju Dong Yang

et al.

Hepatology, Journal Year: 2022, Volume and Issue: unknown, P. n/a - n/a

Published: Sept. 9, 2022

Abstract Hepatocellular carcinoma (HCC) mortality remains high primarily due to late diagnosis as a consequence of failed early detection. Professional societies recommend semi‐annual HCC screening in at‐risk patients with chronic liver disease increase the likelihood curative treatment receipt and improve survival. However, recent dynamic shift etiologies from viral metabolic diseases has significantly increased potential target population for screening, whereas annual incidence rate become substantially lower. Thus, contemporary etiologies, traditional approach might not be practical cost‐effective. consists (i) definition rational population, subsequent (ii) repeated application detection tests at regular intervals. The suboptimal performance currently available highlights an urgent need new modalities strategies In this review, we overview developments clinical, molecular, imaging‐based tools address current challenge, discuss conceptual framework approaches their clinical translation implementation. These encouraging progresses are expected transform “one‐size‐fits‐all” into individualized precision ultimately poor prognosis foreseeable future.

Language: Английский

Citations

60
International Liver Cancer Association (ILCA) white paper on hepatocellular carcinoma risk stratification and surveillance DOI Open Access
Amit G. Singal, Marco Sanduzzi‐Zamparelli, Pierre Nahon

et al.

Journal of Hepatology, Journal Year: 2023, Volume and Issue: 79(1), P. 226 - 239

Published: Feb. 26, 2023

Language: Английский

Citations

40