European Journal of Cancer: Highlights of Issue 40:10

Lack of evidence is a barrier to 'standard' systemic therapy for advanced HCC

Review of systemic therapy for advanced HCC

Nowak and colleagues provide an overview of the therapies that have been used in advanced hepatocellular carcinoma (HCC). They divide their analysis into three main areas; chemotherapy, hormonal therapy and immunotherapy. There is a paucity of large, well-designed clinical trials in advanced HCC to guide therapeutic decisions, they conclude. Trials are often single-centred including too few and highly selected patients making analysis of the results difficult. "It is clear that there is no systemic therapy that can be considered standard for patients with HCC.... Prevention of hepatitis B and C remains vital to decrease deaths from HCC".

Hepatocellular carcinoma incidence in the Netherlands

Age-standardised incidence of hepatocellular carcinoma (HCC) does not rise in the Netherlands between 1989 and 2000. In contrast, mortality due to primary liver cancer increases over the same time period. These are the conclusions of Verhoef and colleagues who analysed in this issue trends in incidence, mortality, treatment and survival according to the patient's gender, age, period of diagnosis and stage of disease. Using data from the Netherlands, in addition to the aforementioned trends, the authors noted that 73% of HCC patients received no cancer-related therapy and treatment patterns did not change over the study period. This suggests that HCC patients should be discussed in specialist centres to minimise the number of patients not receiving curative therapy, they said.

Cathepsin B and L and colorectal cancer progression

Early colorectal cancer progression is associated with the expression of cathepsin B and L antigen and activity levels, according to authors reporting in this issue. Troy and colleagues analysed 99 samples from patients undergoing operations for colorectal cancer and analysed their results as tumour/normal ratios from matched patient samples. The activity ratios decreased gradually with advancing tumour stage. Furthermore, patient survival of those with potentially curable disease was inversely related to the activity ratios for both cathepsins and also to the cathepsin L antigen ratio. Our findings suggest that these cysteine proteases, that are thought to be important for the processes of invasion and metastasis, play an important role in colorectal cancer progression, they said.

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