Methodological assessment of HCC literature

Abstract

Despite the fact that the hepatocellular carcinoma (HCC) represents a major health problem, very few interventions are available for this disease, and only sorafenib is approved for the treatment of advanced disease. Of note, only very few interventions have been thoroughly evaluated over time for HCC patients compared with several hundreds in other, equally highly lethal, tumours. Additionally, clinical trials in HCC have often been questioned for poor design and methodological issues. As a consequence, a gap between what is measured in clinical trials and what clinicians have to face in daily practice often occurs. As a result of this scenario, even the most recent guidelines for treatment of HCC patients use low strength evidence to make recommendations. In this review, we will discuss some of the potential methodological issues hindering a rational development of new treatments for HCC patients.

Integrated analysis of lactate-related genes identifies POLRMT as a novel marker promoting the proliferation, migration and energy metabolism of hepatocellular carcinoma via Wnt/β-Catenin signaling

“…The prognosis of HCC varies depending on individual factors such as the patient's health status, the type of cancer, the stage of the disease, and the treatment methods used. Generally, the prognosis for HCC is relatively poor, especially for patients diagnosed at an advanced stage [21]. HCC often presents with no noticeable symptoms in its early stages, leading to late diagnosis in many cases.…”

BOOST: a phase 3 trial of sorafenib vs. best supportive care in first line treatment of hepatocellular carcinoma in patients with deteriorated liver function

“…However, the efficacy of nivolumab in this setting remains to be demonstrated. A retrospective analysis of a subgroup of 73 patients randomized in the CELESTIAL trial (51 to cabozantinib and 22 to placebo) who progressed to Child-Pugh B class at Week 8 of treatment showed that, while the OS benefit of cabozantinib over placebo was maintained, some Grade 3/4 adverse events (fatigue, ascites, AST elevation, and thrombocytopenia) were more common in the cabozantinib arm, while others (palmarplantar erythrodysesthesia and hypertension) were more frequent in the placebo arm [32] . Thus, systemic treatment of advanced HCC patients with Child-Pugh B liver cirrhosis will remain an unmet need in the next years as well.…”