Prevention is Better Than Cure: Early Stage Liver Cancer Detection Using Liquid Biopsy

The incidence of liver cancer or hepatocellular carcinoma (HCC) has been steadily rising in the United States, secondary to the increased incidence of hepatitis. In the year 2018, an estimated 42,220 adults in the United States have been diagnosed with primary liver cancer. The primary cause of the liver disease is the infection generated by hepatitis B or hepatitis C virus which can result in cirrhosis (scarring) in your liver. Liver cancer cannot be detected at an early stage because signs and symptoms appear only at its later or advanced stages. The biomarkers that are critical in signaling the presence of cancer cannot be detected early in the case of liver cancer.

With the collaborative efforts between National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Sciences and Genetron Health (Beijing) Co. Ltd (Genetron), the scientists published the results of a pilot study for early detection of liver cancer using liquid biopsy, that screens for specific molecules that tumors release into the bloodstream. The sample studied was cohort of HBV carriers at risk for developing the disease and the screening technology was HCCscreen. The biomarkers for the assay included specific mutation profiles from plasma cell-free, cfDNA, along with protein.

The HCCscreen tested a total of 331 HBV carriers (with normal alpha-fetoprotein levels, AFP is a protein that can be present at increased levels in patients with liver cancer, and normal ultrasound). Among them, 24 subjects were identified as positive and 307 (out of 331) as negative. Furthermore, four out of the 24 individuals with a positive HCCscreen test were later diagnosed as having early stage liver cancer (less than 3 cm) within six to eight months. The early detection with HCCscreen, allows earlier intervention with surgery, which significantly increases the likelihood of treatment and survival. On the other hand, none of the HCCscreen-negative individuals were diagnosed clinically with liver cancer in the same follow-up period.

The advantages of this screening technology is that they follow non-invasive blood tests or liquid biopsies, that presents a better and safe alternative to the extraction of tissue biopsies. In addition, cfDNA potentially represents the entire molecular picture of a patient’s malignancy, while a tumor biopsy may be limited to just the tested portion of the tumor. In order to improve and validate the non-invasive detection method, the research team is conducting an extensive clinical trial.

Mr. Sizhen Wang, co-founder and CEO of Genetron, emphasized: “Some developed countries have achieved extraordinary performance in reducing morbidity and mortality of some cancer types, such as colorectal cancer in the United States and gastric cancer in Japan, which need to thank the efficient early screening of the cancers. Genetron is working diligently and would like to launch the product for early screening of liver cancer, therefore, to reduce mortality of liver cancer patients. The similar technology can be adapted and developed to screen other types of cancers after clinical validation, and we are dedicated to providing effective technologies for the early detection of cancer in high-risk populations, as well as in general populations.”

The liquid biopsy screening method holds great promise in improving early detection of HCC, advancing patient prognosis, and ultimately increasing the survival rate.

Sources: Medical Xpress, EurekAlert, Elsevier