View clinical trials related to Hepatocellular Carcinoma.
Filter by:HCC (Hepato-cellular Carcinoma) is the fifth most frequent cancer in humans and its prevalence is growing. The most effective treatment of HCC is surgical and includes resection and liver transplantation; however, only 20% of the patients can be treated surgically. Local interventional therapy, such as radiofrequency (RF) ablation and transarterial embolization is also used. Recurrence rate is very high, and extrahepatic disease develops in about 30% of the cases and in up to 20% after liver transplantation. Systemic treatment is thus an option. Sorafenib (multi-kinase inhibitor) is the first agent to significantly improve the overall survival in advanced HCC. However, the drug has serious side effects and is very expensive. PET/CT with F18-FDG is a common tool for systemic evaluation and staging of various tumors. The value of the FDG PET for evaluation of HCC is controversial, in particular due to the unique metabolic pathway of glucose in the HCC cells. Since 2007 more and more studies suggest the feasibility of FDG PET/CT for monitoring local recurrence (especially after RF) and metastatic spread of HCC, including detection of active disease only suspected by AFP (alphafoetoprotein) elevation. Early detection of treatment response to therapy by whole body FDG PET/CT allows for change of treatment as early as possible,when the tumor is non-responsive before serious side effects appear or before depletion of body resources. The aim of our study is to investigate the contribution of FDG PET/CT to assessment of treatment response.
This study aims at testing the utility of PET Scan as a screening tool for liver transplantation in patients with Hepatocellular Carcinoma. Patients being worked up for liver transplant for hepatocellular carcinoma will undergo a PET Scan and will be followed until 2 years after transplantation. At that time survival data will be analysed according to PET Scan results to determine if it can be used to predict outcome.
This study aims to test the efficacy of combined radiotherapy and sorafenib in patients with locally advanced hepatocellular carcinoma.
Specific urine proteases or groups of these enzymes can be reliable biomarkers and an effective gauge of response to therapy in patients with hepatocellular carcinoma.
The purpose of this study is to determine efficacy of SB injection in Hepatocellular Carcinoma (HCC).
Indication : Hepatocellular carcinoma, maximum size 9 cm, with single or multiple nodes whose total tumor mass can technically be irradiated, non-resectable, and not a candidate for percutaneous therapy with recommended treatment via hyperselective transarterial chemoembolisation (TACE).
This is a prospective pilot study that will document the clinical experience of 30 patients with unresectable hepatocellular carcinoma undergoing liver-directed therapy with Yttrium-90 glass microspheres (TheraSphere®).
This is a study of ADI-PEG 20 (pegylated arginine deiminase), an arginine degrading enzyme versus placebo in patients with hepatocellular carcinoma who have failed prior systemic treatment (chemotherapy). Hepatocellular carcinomas have been found to require arginine, an amino acid. Thus the hypothesis is that by restricting arginine with ADI-PEG 20, the hepatocellular carcinoma cells will starve and die.
Hepatocellular carcinoma (HCC) is a major health problem worldwide. For patients with intermediate-stage disease, i.e., large or multifocal HCC without vascular invasion or extrahepatic spread, transarterial chemoembolization (TACE) is recommended as first line therapy with survival advantages. TACE can be performed repeatedly in patients with recurrent tumors who have adequate liver function reserves. Two clinical issues of TACE remain un-resolved. The first issue is the possibility of TACE-induced liver parenchymal damage, which may influence further treatment options and outcome of the patients. Conventional ways to evaluate liver functional reserves, including Child-Pugh score, biochemistry and metabolic tests, and ultrasound elastography, are relatively non-specific. The second issue is the difficulty in evaluating TACE efficacy, which cannot be reliably measured by conventional, volumetric response criteria. Both issues should be resolved to optimize patient care. Recently dynamic contrast-enhancing magnetic resonance imaging (DCE-MRI) is increasingly used to analysis perfusion changes of the liver, and can be applied to both liver parenchyma and tumors. Previous studies have shown clinical applications of perfusion imaging, such as evaluating the severity of liver fibrosis and cirrhosis, assessing the effectiveness of anti-angiogenic therapy, and evaluating tumor viability after locoregional therapy. DCE-MRI can be performed with a hepatobiliary specific contrast agent, Gd-EOB-DTPA (Gadoxetic acid, Primovist®, Bayer Schering), with dual benefit of dynamic phase and the delayed hepatobiliary phase imaging. The hepatobiliary phase imaging can provide additional information for hepatic lesion characterization and the functional status of the hepatocytes. We hypothesize that imaging parameters of DCE-MRI with Gd-EOB-DTPA could reflect non-tumorous liver parenchymal changes and can be used to predict and monitor treatment response in patients with HCC after TACE. In this prospective cohort study, we will recruit patients referred for TACE with newly-diagnosed unresectable HCC or tumor recurrence after operation. Patients treated with radiofrequency ablation (RFA) will be recruited as a control group, since RFA is associated with minimal damage to the non-tumorous liver parenchyma. Key eligible criteria include chronic hepatitis B, histological or clinical diagnosis of HCC, tumors that are not amenable to surgical treatment and referred for TACE or RFA, ECOG performance status 0 or 1, Child-Pugh class A or B liver function, and measurable tumors (by RECIST 1.1). Eligible patients will receive the designated treatment (TACE or RFA) according to the current HCC treatment guidelines. DCE-MRI with Gd-EOB-DTPA will be used to analyze the non-tumorous liver parenchymal changes and treatment response, and will be performed at baseline, 3 days and 1 month after treatment, and then every 3 months for a maximum of 2 years. The primary endpoint of this study is progression of liver function reserve. The estimated time for patient recruitment is about half a year, and 40 patients and 20 patients will be recruited in the TACE and the RFA treatment group, respectively. The imaging parameters of the non-tumorous parenchyma and the tumors will be analyzed and correlated with clinical liver function parameters, and hepatic functional and tumor outcome of the patients.
There is no prospective study on the test intervals of alpha-fetoprotein (AFP) or on the role of prothrombin induced vitamin K absence or antagonist-II (PIVKA-II) in surveillance program for early detection of hepatocellular carcinoma(HCC). The goal of this study is to compare if the testing of AFP + PIVKA-II in intervals of 3 months is more effective in diagnosing early stages of HCC than the 6 month interval of AFP that is commonly used