Immunofluorescent study of alpha-foetoprotein (αfp) in liver and liver tumours. II. Localization of αfp in the tissues of patients with primary liver cancer (PLC)

14106 Background: Due to extent of tumour and underlying liver disease primary liver cancer, hepatocellular(HCC) as well as cholangiocellular(CCC), has extremely poor prognosis. The tyrosinekinase and mTOR inhibitor sirolimus, is registered for preventing allograft rejection. It retard experimental liver tumours in rats, and has antiangiogenic effects as well. Methods: Patients with a nonoperable HCC or CCC, with a Karnofsky >70, and the diagnosis confirmed by biopsy or alfa-fetoprotein (>700ug/ml) were eligible. Ethic committee approved the study and informed consent was signed. The daily Sirolimus dose was adjusted to a 6–10 μg/L through-concentration.Twenty patients were to be enrolled in a nonrandomized study. The primary endpoint was to detect a radiological tumor response rate, defined by RECIST criteria, and secondary endpoint was to study the safety profile. CT or MRI were repeated every third month. The study was approved by the Etic Committee of Göteborg University. Results: Eleven patients with HCC and nine with CCC were included. Overall respone rate was 5%, which ocurred in a patient patient with HCC. The PR lasted for 15 months (RR 9% for HCC). Four patients with HCC had SD for median 7 months (range 5–18). Of the patients with CCC four had SD. Median duration of SD was 4 months (range 1 - 7). Median survival for patients with HCC was 7 months (range 2–20) and CCC 4 months (range 2–24) Discussion: There is low evidence supporting the use of chemotherapy for primary liver cancer. For HCC, one PR and 4 SD in this pilot study indicate that sirolimus might be of interest to study in a phase II trial, since the toxicity of sirolimus was low. In the european SILVER study,the impact of sirolimus for patients transplanted for HCC will be clarified. Experimentally, the antiangiogenetic effects of sirolimus has been boosted by combining with 5-FU and gemcitabine. This might translate to impoved response rate also for liver cancer. Conclusions: This pilot study suggests that sirolimus have a tumour effect in patients with HCC. No significant financial relationships to disclose.

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Recreating Tumour Complexity in a Dish: Organoid Models to Study Liver Cancer Cells and their Extracellular Environment

Cancers ◽

10.3390/cancers11111706 ◽

2019 ◽

Vol 11 (11) ◽

pp. 1706 ◽

Cited By ~ 7

Author(s):

van Tienderen ◽

Groot Koerkamp ◽

IJzermans ◽

van der Laan ◽

Verstegen

Keyword(s):

Liver Cancer ◽

Cancer Progression ◽

Primary Liver Cancer ◽

Tumour Microenvironment ◽

In Vitro Models ◽

Experimental Models ◽

Liver Tumours ◽

Extracellular Environment

Primary liver cancer, consisting predominantly of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA), remains one of the most lethal malignancies worldwide. This high malignancy is related to the complex and dynamic interactions between tumour cells, stromal cells and the extracellular environment. Novel in vitro models that can recapitulate the tumour are essential in increasing our understanding of liver cancer. Herein, primary liver cancer-derived organoids have opened up new avenues due to their patient-specificity, self-organizing ability and potential recapitulation of many of the tumour properties. Organoids are solely of epithelial origin, but incorporation into co-culture models can enable the investigation of the cellular component of the tumour microenvironment. However, the extracellular component also plays a vital role in cancer progression and representation is lacking within current in vitro models. In this review, organoid technology is discussed in the context of liver cancer models through comparisons to other cell culture systems. In addition, the role of the tumour extracellular environment in primary liver cancer will be highlighted with an emphasis on its importance in in vitro modelling. Converging novel organoid-based models with models incorporating the native tumour microenvironment could lead to experimental models that can better recapitulate liver tumours in vivo.

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Hepatobiliary phenotypes of adults with alpha-1 antitrypsin deficiency

Gut ◽

10.1136/gutjnl-2020-323729 ◽

2021 ◽

pp. gutjnl-2020-323729

Author(s):

Malin Fromme ◽

Carolin V Schneider ◽

Vitor Pereira ◽

Karim Hamesch ◽

Monica Pons ◽

...

Keyword(s):

Liver Fibrosis ◽

Liver Cancer ◽

Liver Enzymes ◽

Primary Liver Cancer ◽

Uk Biobank ◽

Liver Tumours ◽

Elevated Liver Enzymes ◽

Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin

ObjectiveAlpha-1 antitrypsin deficiency (AATD) is a common, potentially lethal inborn disorder caused by mutations in alpha-1 antitrypsin (AAT). Homozygosity for the ‘Pi*Z’ variant of AAT (Pi*ZZ genotype) causes lung and liver disease, whereas heterozygous ‘Pi*Z’ carriage (Pi*MZ genotype) predisposes to gallstones and liver fibrosis. The clinical significance of the more common ‘Pi*S’ variant remains largely undefined and no robust data exist on the prevalence of liver tumours in AATD.DesignBaseline phenotypes of AATD individuals and non-carriers were analysed in 482 380 participants in the UK Biobank. 1104 participants of a multinational cohort (586 Pi*ZZ, 239 Pi*SZ, 279 non-carriers) underwent a comprehensive clinical assessment. Associations were adjusted for age, sex, body mass index, diabetes and alcohol consumption.ResultsAmong UK Biobank participants, Pi*ZZ individuals displayed the highest liver enzyme values, the highest occurrence of liver fibrosis/cirrhosis (adjusted OR (aOR)=21.7 (8.8–53.7)) and primary liver cancer (aOR=44.5 (10.8–183.6)). Subjects with Pi*MZ genotype had slightly elevated liver enzymes and moderately increased odds for liver fibrosis/cirrhosis (aOR=1.7 (1.2–2.2)) and cholelithiasis (aOR=1.3 (1.2–1.4)). Individuals with homozygous Pi*S mutation (Pi*SS genotype) harboured minimally elevated alanine aminotransferase values, but no other hepatobiliary abnormalities. Pi*SZ participants displayed higher liver enzymes, more frequent liver fibrosis/cirrhosis (aOR=3.1 (1.1–8.2)) and primary liver cancer (aOR=6.6 (1.6–26.9)). The higher fibrosis burden was confirmed in a multinational cohort. Male sex, age ≥50 years, obesity and the presence of diabetes were associated with significant liver fibrosis.ConclusionOur study defines the hepatobiliary phenotype of individuals with the most relevant AATD genotypes including their predisposition to liver tumours, thereby allowing evidence-based advice and individualised hepatological surveillance.

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