Combination Therapy Achieves Long-Term Remission in Advanced Liver Cancer Patients

A recent study led by researchers from the University of Hong Kong has shown promising results for patients with advanced liver cancer, indicating that a novel combination of locoregional therapy and immunotherapy (LRT-IO) can lead to long-term remission in nearly half of those treated. This groundbreaking research, published in JAMA Oncology, highlights the potential of this treatment to transform the management of what is often considered an incurable disease.

Advanced liver cancer, particularly hepatocellular carcinoma, has limited treatment options and is typically viewed as a terminal condition. However, this study suggests that through the innovative LRT-IO approach, significant numbers of patients can achieve a complete response, allowing for transformative outcomes.

The research team monitored 63 patients diagnosed with unresectable liver cancer who underwent the LRT-IO treatment from January 2018 to December 2022. With a median tumor size of 10 cm, the patients were followed for almost three years. Impressively, 46% of these individuals achieved a complete response, with two-thirds remaining free of cancer at the time of the last follow-up in June 2023.

Data indicated a stark difference in survival rates: patients who achieved a complete response exhibited a three-year overall survival rate of 76%, compared to just 28% in those who did not respond completely to the treatment. This outcome aligns with survival rates typically seen in patients who undergo curative surgical procedures, underlining the effectiveness of the LRT-IO strategy.

The LRT-IO regimen consists of stereotactic beam radiotherapy (SBRT), which may be combined with transarterial chemoembolization (TACE), followed by immunotherapy. Previous studies indicated that 42% of patients experienced complete cancer disappearance post-treatment, further supporting the efficacy of this combined therapeutic approach.

While one-third of the patients in this study did experience a recurrence of their cancer, it was notable that 60% of these cases allowed for curative surgery to be considered as a treatment option. The findings underscore the importance of achieving a complete response and its impact on improving long-term patient outcomes.

The implications of this study are significant. It not only provides a potential new pathway for treating advanced liver cancer but also sets the stage for further advancements in treatment protocols. For patients who are older, medically unfit, or have other complicating factors that make surgery impractical, this study offers a viable alternative that does not necessitate immediate surgical intervention.

Moreover, the findings advocate for a 'watch-and-wait' strategy post-treatment, especially for those patients who have demonstrated a complete response to LRT-IO. This strategy could change clinical management practices for liver cancer, offering hope where there was once little.

The research team is optimistic that their findings will influence future guidelines for liver cancer treatment, following the inclusion of a similar approach in the National Guidelines for the Management of Liver Cancer in China in 2024. The continued promotion of this treatment at local and national conferences aims to encourage broader adoption within clinical practices.

As the researchers continue to explore effective strategies against this formidable cancer, their commitment to improving patient outcomes remains steadfast. As Professor Chan Chi-yan and Dr. Chiang Chi-leung lead these initiatives, they aim to further validate and refine treatment protocols that could ultimately save lives.