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Clinical application of computerized tomography-guided microwave ablation in the treatment of hepatitis B-related hepatocellular carcinoma oligosenterinoma Hu Caixia, Zhao Peng, Liu Bojun, Yang Xiaozhen, Fang Da, Zheng Jiasheng, Zhang Yonghong Electronic Journal of Liver Tumor    2024, 11 (1): 1-3.   Abstract （84）      PDF （1509KB）（29）       Knowledge map    Save Objective: To evaluate the efficacy, safety and application value of microwave ablation for patients with liver cancer associated with hepatitis B and lung metastases in the era of pre-target immunotherapy. Methods: From November 2010 to December 2014,30 patients (24 males and 6 females) with pulmonary metastases were treated by microwave ablation Age ranged from 35 to 74 years, with a median age of 57.1 years. 67 pulmonary metastases were detected by chest CT and 67 lesions were ablated. The diameter of the tumor ranged from 0.5 cm to 4.1 cm in 9 patients with single lesion, 5 patients with 2 lesions and 16 patients with 3 lesions, the average diameter was 1.37 cm. Kaplan-meier method was used to calculate local tumor control rate, median survival time and complications. Results: Microwave ablation was successfully performed 46 times in 67 cases of liver cancer with lung metastases. One to three months after ablation, enhanced CT showed no enhancement in the target area. The complete ablation rate was 100% , and the median survival time was 27.5 months, the main complications included local pain (6 cases) , paroxysmal cough (13 cases) and a small amount of hemoptysis (3 cases) , 10 patients developed mild pneumothorax without special treatment, and 3 patients developed moderate to severe pneumothorax. Immediate closed chest drainage was performed. Conclusion: CT-guided microwave ablation is a safe and effective method for the treatment of lung metastases from hepatitis B-related liver cancer. Reference | Related Articles | Metrics

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Prognosis and risk factors of different recurrence patterns after hepatectomy for colorectal liver metastasis Chen Hanwei, Li Lei Electronic Journal of Liver Tumor    2024, 11 (2): 27-32.   Abstract （80）      PDF （3700KB）（20）       Knowledge map    Save Objective: To study the prognostic differences and risk factors of different recurrence patterns after hepatectomy for colorectal liver metastasis. Methods: The general data, clinical data and follow-up data of patients with colorectal liver metastasis who underwent hepatectomy in the Department of General Surgery of Peking University Third Hospital from January 2009 to February 2023 were collected. Kaplan-Meier curve was used to analyze the survival differences between different recurrence times and different recurrence sites. The maximally selected test was used to find the optimal cut-off value of recurrence time for distinguishing the survival after recurrence. Logistic regression analysis were used to analyze the risk factors of early recurrence. Results: A total of 281 patients met the inclusion and exclusion criteria. There were statistically significant differences in mortality and overall survival between patients with and without postoperative recurrence (P=0.001). The optimal cut-off value for distinguishing early and late recurrence was 12 months (P=0.001). There was a statistically significant difference in the post-recurrence survival between patients with early recurrence and late recurrence (P=0.001 1). There was a statistically significant difference in the post-recurrence survival between different recurrence sites (P=0.002 3), and the prognosis of patients with the first recurrence site in the lung was the best. Logistic regression analysis showed that patients with positive lymph node metastasis of primary tumor (OR=2.294, 95%CI:1.171-4.496, P=0.019), preoperative CEA≥5.31 ng/ml (OR=2.160, 95%CI:1.001-4.660, P=0.049 8) and preoperative CA19-9≥ 40.52 U/ml (OR=2.210, 95%CI:1.030-4.741, P=0.042) were at high risk of early recurrence after surgery. Conclusions: The recurrence within 12 months and extrapulmonary recurrence is associated with poor prognosis. The risk factors for early recurrence include positive lymph node metastasis of primary tumor, preoperative CEA≥5.31 ng/ml and preoperative CA19-9≥ 40.52 U/ml. Patients with related risk factors should be actively reviewed and monitored. Reference | Related Articles | Metrics

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Effect of targeted nursing management on patients with liver cancer after radiotherapy Du Mengya, Chen Peijuan, Sun Jingyuan Electronic Journal of Liver Tumor    2024, 11 (1): 34-37.   Abstract （74）      PDF （1597KB）（11）       Knowledge map    Save Objective: To explore the intervention effect of targeted nursing in radiotherapy of liver cancer patients. Methods: From October 2017 to October 2019, 208 patients with liver cancer undergoing radiotherapy in our hospital were selected and randomly divided into control group (106 cases) and experimental group (102 cases). The two groups were given targeted nursing and routine nursing respectively. Baseline data were compared between the two groups, as well as visual analog pain scores, anxiety and depression scores, quality of life scores, complication rate, compliance, and satisfaction with care. Results: There was no significant difference in visual analog pain scores, anxiety and depression scores, and quality of life scores between the two groups before the targeted intervention (all P> 0.05). After 3 months of care, the visual analog pain, anxiety, depression and quality of life were higher than the control group (all P<0.05); the complication rate was lower than the control group (9.8% vs 30.2%, P<0.05), and the compliance was better than the control group (96.07% vs 84.91%, P<0.05); the nursing satisfaction was higher than the control group (all P<0.05). Conclusion: Targeted nursing can reduce the complications of patients with liver cancer radiotherapy, improve the overall satisfaction of patients. Reference | Related Articles | Metrics

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Molecular characterization of KRAS G12C mutation in the tumors of digestive system Zhao Tingqi, Dong Lin, Ying Jianming, Li Weihua Electronic Journal of Liver Tumor    2024, 11 (1): 4-8.   Abstract （68）      PDF （1777KB）（23）       Knowledge map    Save Objective: To identified the molecular characteristics of KRAS G12C mutation in the tumors of digestive system. Methods: Data of 1 100 patients diagnosed as digestive malignant tumor in Cancer Hospital of Chinese Academy of Medical Sciences from 2017 to 2022 were collected. The microsatellite status, tumor mutation burden (TMB) and KRAS, NRAS, BRAF and PIK3CA mutations were detected by next-generation sequencing in 1 100 patients with tumors of digestive system, including colorectal adenocarcinoma, duodenal adenocarcinoma, cholangiocarcinoma, gastric adenocarcinoma, ileocecal adenocarcinoma and pancreatic ductal adenocarcinoma. Results: Microsatellite instability-high (MSI-H) tumors were most common in duodenal adenocarcinoma (19%), followed by ileocecal adenocarcinoma (18%) and colorectal adenocarcinoma (10.2%). However, no MSI-H tumors were detected in the 100 cases of pancreatic ductal adenocarcinoma. TMB values also varied among different tumors of digestive system. High-TMB (≥10 mut/Mb) tumors were most common in ileocecal adenocarcinoma (24%), followed by duodenal adenocarcinoma (22%) and gastric adenocarcinoma (18.9%). KRAS mutations were detected in 452 of 1 100 (41.09%) cases, among which the most common tumor was pancreatic ductal adenocarcinoma (85.0%), followed by duodenal adenocarcinoma (56%) and ileocecal adenocarcinoma (53%). However, KRAS mutations were identified in 7.3% of gastric adenocarcinoma. KRAS G12C mutation was detected in 2.82% of all the 1 100 tumors, and only 6.9% (31/452) of all digestive tumors with KRAS mutations among which the most common tumor was ileocecal adenocarcinoma (2/9), followed by duodenal adenocarcinoma (13%) and colorectal adenocarcinoma (8.8%). However, no significant differences in gender, age, MSI and TMB status were observed between patients with KRAS G12C mutation and other KRAS mutation subtypes. Conclusions: Although nearly half of patients with digestive malignancies carry KRAS mutations, but only 6.9% of KRAS-mutant cases harbored KRAS G12C mutation subtype. KRAS G12C mutation was most common in ileocecal cancer, duodenal cancer and colorectal cancer. And no obvious difference in clinical and molecular pathological features compared with other types of KRAS mutations Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2024, 11 (3): 1-13.   Abstract （68）      PDF （1944KB）（406）       Knowledge map    Save Reference | Related Articles | Metrics

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Clinical application progress of circulating tumor cells for accurate dynamic monitoring of hepatocellular carcinoma Huang Xiaozhun, Wang Fuzun, Xie Yunliang, Ran Yihong, Xu Lin, Huang Zhangkan, Yin Xin, Bi Xinyu, Che Xu Electronic Journal of Liver Tumor    2024, 11 (1): 21-24.   Abstract （66）      PDF （1596KB）（21）       Knowledge map    Save Hepatocellular carcinoma (HCC) is the fifth most common neoplasm and a major cause of cancer-related death worldwide. There is no ideal biomarker allowing early diagnosis of HCC and tumor surveillance in patients receiving therapy. Circulating tumor cells (CTC) have become a useful tool for diagnosing and monitoring therapeutic responses of different tumors in a non-invasive setting, and have great potential for precision medicine delivery in HCC patients. Based on existing clinical application evidence, this review will discuss the application and research progress of CTC in guiding surgical methods, resection margins, interventional therapy and systematic therapy, and other accurate dynamic monitoring. Reference | Related Articles | Metrics

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A Meta-analysis of the curative effect and safety of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of large liver cancer Li Mei, Qiao Bei, Zhang Zhihao Electronic Journal of Liver Tumor    2024, 11 (1): 9-15.   Abstract （63）      PDF （7001KB）（16）       Knowledge map    Save Objective: Through Meta-analysis, compared with transcatheter arterial chemoembolization (TACE) alone, to analyze the curative effect and safety of TACE combined with radiofrequency ablation (RFA) in treating large liver cancers. Method: According to the Meta-analysis process, the relevant domestic and foreign related databases such as PubMed, Embase, Seer, Cochrane Library, CNKI, Wanfang Medical Network, VIP, China Biomedical Literature Database were searched with defined search terms. The search period was January 2003 to June 2023. Randomized controlled clinical studies on the efficacy and safety of TACE+RFA versus TACE alone in the treatment of large liver cancer were screened and included. The quality of the included studies was evaluated and Meta-analysis was performed using RevMan5.4 software. Result:Finally, A total of 16 papers were included, involving 1 175 patients, including 587 cases in the TACE+RFA group and 588 cases in the TACE alone group. The results of Meta-analysis indicated that: compared with the TACE alone group, the objective response rate (ORR) [relative risk (RR)=1.46, 95% confidence interval (95%CI): 1.35-1.59, P<0.000 01], disease control rate (DCR) (RR=1.17, 95%CI: 1.12-1.22, P<0.000 01), 1-year survival rate (RR=1.39, 95%CI: 1.24-1.55, P<0.000 01), 2-year survival rate (RR=1.79, 95%CI: 1.38-2.32, P<0.000 1) and 3-year survival rate (RR=3.20, 95%CI: 1.25-8.20, P=0.02) of TACE+RFA group were better than those of simple TACE group, and the difference was statistically significant. There was no significant difference in the common adverse reactions between the two groups. Conclusion: Compared with TACE alone, TACE+RFA can improve the short-term efficacy and the long-term survival rate of large liver cancer patients, and does not increase the occurrence of adverse reactions. Reference | Related Articles | Metrics

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Research progress in the liquid biopsy in hepatocellular carcinoma Liang Renshan, Zhang Yu, Chen Zutao, Feng Tingting Electronic Journal of Liver Tumor    2024, 11 (1): 30-33.   Abstract （61）      PDF （1660KB）（14）       Knowledge map    Save At present, primary hepatocellular carcinoma ranks fourth common malignant tumor and second tumor cause of death in China, seriously threatening the pubic life and health.Because of its hidden incidence and non-specific clinical manifestations, the early diagnosis rate of primary liver cancer is low.When liver cancer is found,the condition often have progressed to the advanced stage and the prognosis is very poor.Therefore, modern medicine there is an urgent need for new detection methods to early diagnosis, real-time monitoring and effective treatment of liver cancer."Liquid biopsy" is one of the new detection methods.Many studies have shown that liquid biopsy is of great significance in the early diagnosis, targeted treatment, metastasis, recurrence and prognostic evaluation of liver cancer. The purpose of this review is to briefly introduce the research progress of liquid biopsy in hepatocellular carcinoma. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2024, 11 (4): 63-66.   Abstract （58）      PDF （1701KB）（11）       Knowledge map    Save Related Articles | Metrics

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Analysis of clinical features of multiple primary tumors associated with liver cancer Wu Wenqi, Wang Hao, Wang Yuxia Electronic Journal of Liver Tumor    2024, 11 (2): 33-36.   Abstract （57）      PDF （1988KB）（11）       Knowledge map    Save Objective: To explore the clinical epidemiological characteristics and survival outcomes of patients with multiple primary malignant tumors (MPMTs) combined with liver cancer. Methods: From August 2010 to June 2023, patients with liver cancer were selected from malignant tumor patients admitted to the Cancer Center of Peking University Third Hospital. The basic information of the patients and the incidence information of liver cancer and other tumors were collected to make comparisons between MPMTs and single liver cancer, also groups with liver cancer as the first or the second primary cancer. Results: The incidence of liver cancer combined with extraneous tumors was accounting for 13.1% (23/176) of liver cancer patients during the same period. Among the patients, 5 had synchronous multiple primary tumors, and 18 had metachronous multiple primary tumors. Of these patients, 9 had liver cancer as the first primary tumor, and 9 had liver cancer as the second primary tumor. Liver cancer patients with family history of cancer were more likely to have multiple primary tumors (χ2=5.22, P=0.030). Liver cancer as the first primary tumor had a shorter interval for multiple primary tumor onset compared to liver cancer as the second primary tumor (35 month vs. 156 month, P=0.009). The onset interval was negatively correlated with the diagnosis age of the first primary tumor (r=-0.60, P=0.009). Conclusions: Multiple primary tumors associated with liver cancer tend to occur in patients with a family history of cancer. There was a difference in the tumor incidence interval between multiple primary cancers with liver cancer as the first primary tumor and multiple primary cancers with liver cancer as the second primary tumor. Reference | Related Articles | Metrics

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Research progress on conversion therapy for patients with malignant liver tumors with inadequate remnant liver volume Li Xin, Li Zhiyu Electronic Journal of Liver Tumor    2024, 11 (1): 16-20.   Abstract （56）      PDF （1646KB）（27）       Knowledge map    Save For patients with primary or locally metastatic malignant liver tumors,the only chance for long-term survival is complete resection of the liver tumors. However, post-hepatectomy liver failure(PHLF) remains a major cause of mortality after liver resection,and inadequate future liver remnant has been proven to be a major risk factor for PHLF. Currently,various methods exist for preoperative conversion therapy. Portal vein embolization and associating liver partition and portal vein ligation for staged hepatectomy are the two most widely used methods. However, each method has its distinct advantages and disadvantages. With the development of comprehensive treatment for malignant tumors, several treatment methods are under exploration. This study compares different conversion therapy methods,aiming to provide clinical references. Reference | Related Articles | Metrics

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Efficacy and safety of bevacizumab with nab-paclitaxel and tegafur gimeracil oteracil potassium capsule (S-1) in advanced biliary tract adenocarcinoma Zhang Chao, Sun Yongkun, Su Aijiang, Zhao Jianjun, Zhou Jianguo, Li Zhiyu, Zhou Hua, Zhao Pan, Chen Nan, Liu Na Electronic Journal of Liver Tumor    2024, 11 (2): 61-65.   Abstract （56）      PDF （2199KB）（20）       Knowledge map    Save Objective: To evaluate the efficacy and safety of bevacizumab with nab-paclitaxel and tegafur gimeracil oteracil potassium capsule (S-1) in advanced biliary tract adenocarcinoma patients. Method: Totally 22 stageⅣ biliary tract adenocarcinoma patients were enrolled in this single arm, single center prospective phaseⅡ study. Patients were treated with bevacizumab at a dose of 5 mg/kg on day 1, nab-paclitaxel at a dose of 150 mg/m2 on day 1 and S-1, 40 to 60 mg bid/day on days 1-10 of a 14-day cycle. Treatments were repeated until disease progression or unacceptable toxicity occurred. The primary endpoint was objective response rate (ORR). The secondary endpoints were median progression-free survival (PFS), disease control rate (DCR), and adverse events (AEs). Result: The number of patients enrolled were 22, and 21 patients were evaluated for efficacy, with a median of 6 cycles of treatment and a median of 2 lines of treatment. A total of 9 patients achieved partial response (PR) with an ORR of 42.9%(9/21), DCR was 85.7%(18/21). 3 progressive disease was observed. The median PFS were 8 months (95% confidence interval [95%CI]: 4.5~11.5). The incidence of grade 3 treatment-related adverse events in 22 patients was 68.2%(15/22), and there were no grade 4 treatment-related adverse events. The most common grade 3 or 4 toxicities were neutropenia (18.1%), Thrombocytopenia in 2 cases (9.1%), gastrointestinal reaction in 2 cases (9.1%), increased total bilirubin (TBIL)/direct bilirubin (DBIL) in 1 case (4.5%), anemia in 1 case (4.5%), others including neurotoxicity, elevated aminotransferase, bleeding, diarrhea, fatigue, elevation of blood pressure, proteinuria, etc., were grade 1 to 2. During treatment, 4 cases (18.1%) were combined with infection, 3 cases stopped treatment due to adverse events, and there were no treatment-related deaths. Conclusion: The combination of bevacizumab with nab-paclitaxel and S-1 showed explicit antitumor activities and favorable safety profile in advanced biliary tract adenocarcinoma patients, which has good clinical therapeutic value. Reference | Related Articles | Metrics

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A network Meta-analysis of the impact of various teaching methods on medical students' doctor-patient communication Yang Min, Zhou Yongjia, Xu Caihua, Liu Jingyi, Zhou Haiyan, Li Jiang, Cong Minghua Electronic Journal of Liver Tumor    2025, 12 (2): 44-53.   Abstract （54）      PDF （4063KB）（0）       Knowledge map    Save Objective: To compare the effectiveness of different teaching methods in enhancing the communication skills of medical students in China, providing evidence-based recommendations for optimal teaching strategies. Methods: From the establishment of the library until October 15, 2024, a systematic search was conducted in seven databases, including China National Knowledge Infrastructure, China Biomedical Literature Database, PubMed, and Web of Science, to evaluate teaching methods on doctor-patient communication among Chinese medical students. Two independent reviewers screened the studies, extracted relevant data, assessed the risk of bias, and performed statistical analyses. Results: A total of 26 studies involving 2 045 participants and 14 different teaching methods were included. Network Meta-analysis and cumulative ranking probability plots indicated that case-based learning combined with standardized patient teaching (weighted mean difference [WMD]=7.68, 95% confidence interval [95%CI]: 4.76-10.59) and small private online course combined with case-based learning (WMD=7.67, 95%CI: 1.04-14.30) were the most effective in improving medical students' doctor-patient communication skills. Subgroup analysis showed that case-based learning alone was more effective in improving communication skills among medical students and interns, while case-based learning combined with standardized patient teaching was more effective for residents and attending physicians. Conclusion: Case-based learning combined with standardized patient learning or small private online course appear to be superior to other teaching methods for enhancing doctor-patient communication skills. However, the selection of teaching strategies should be tailored to the specific characteristics of the learners to maximize effectiveness in practical applications. Reference | Related Articles | Metrics

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The effects of acceptance and commitment therapy psychological intervention on negative emotion and treatment compliance of patients with primary liver cancer Sun Yali, Tong Huanqing, Yuan Pomian, Liu Le, Wu Na, Zhou Kan, Zhai Jiuling Electronic Journal of Liver Tumor    2024, 11 (1): 38-41.   Abstract （52）      PDF （1508KB）（10）       Knowledge map    Save Objective: To investigate the effects of acceptance and commitment therapy (ACT) psychological intervention on negative emotion and treatment compliance of patients with primary liver cancer. Method: Totally 100 patients were choose with primary liver cancer in our department for the observation object from May 2019 to April 2021. According to the admission time order using a random digital table to divide the patient into 50 cases of intervention group and control group. And the control group were given conventional care, intervention group implements ACT psychological intervention on the basis of regular care. Compared the results of the two groups. Result: Anxiety and self-evaluation scale (SAS) rating / depression self-evaluation schedule (SDS) score of the intervention group is lower than that of the control group [96.0%(48/50) vs 78.0%(39/50), χ2=5.315, P<0.05]. The treatment compliance of the intervention group was higher than that of the control group [(49.3±1.7) vs (53.0±1.6), t=11.525, P<0.001; (44.2±1.5) vs (48.9±1.5), t=15.969,P<0.001]. Conclusion: Application of ACT psychological intervention, can reduce negative emotion of patients with primary liver cancer to improve their treatment compliance, reduce patient psychological pressure, thereby improving the survival quality of patients. Reference | Related Articles | Metrics

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Electronic Journal of Liver Tumor    2024, 11 (1): 47-49.   Abstract （52）      PDF （1635KB）（19）       Knowledge map    Save Related Articles | Metrics

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Research progress of lenvatinib for hepatocellular carcinoma Pei Xirui, Li Xiaohang Electronic Journal of Liver Tumor    2024, 11 (1): 25-29.   Abstract （50）      PDF （1617KB）（21）       Knowledge map    Save Hepatocellular carcinoma is a major challenge affecting global health and has been recognised as a leading cause of death both in China and the world. Due to its insidious, rapidly progressive and highly malignant nature, many patients with hepatocellular carcinoma have already lost their chance of surgery by the time they are diagnosed. Lenvatinib has the ability to inhibit the growth of both tumor cells and tumor angiogenesis, which results in a better effect on patients with unresectable hepatocellular carcinoma and significantly prolongs the overall survival of patients. Therefore, lenvatinib is considered as a first-line target drug for the treatment of unresectable hepatocellular carcinoma. This article presents a systematic review about the research progress of lenvatinib for hepatocellular carcinoma and future perspectives. Reference | Related Articles | Metrics

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Global liver and gallbladder cancer incidence and mortality in 2022 and projections to 2050 Liu Manqi, Xu Mengyuan, Shan Tianhao, Zhao Hong, Zeng Hongmei, Cai Jianqiang Electronic Journal of Liver Tumor    2024, 11 (2): 53-60.   Abstract （49）      PDF （2821KB）（30）       Knowledge map    Save Objective: To analyze the global epidemiological profiles of liver and gallbladder cancer in 2022, and project the global burden of cancer incidence and mortality until 2050. Methods: Based on the GLOBOCAN 2022 database, we analyzed the global burden of liver and gallbladder cancer in 2022 and the projected disease burden in 2050. We calculated age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) by using Segi's world standard population structure data. We estimated the future number of cases and deaths by 2050 based on world population prospects. Results: In 2022, there were an estimated 866,136 new cases and 758,725 deaths from liver cancer, corresponding to ASIRs and ASMRs of 8.6 per 100,000 and 7.4 per 100,000, respectively. There were an estimated 122,491 new cases and 89,055 deaths from gallbladder cancer, corresponding to ASIRs and ASMRs of 1.2 per 100,000 and 0.83 per 100,000, respectively. Incidence and mortality rates of liver cancer were higher in males than in females across different age groups, and gallbladder cancer displayed higher rates among females compared to males. The country with the highest ASIR and ASMR for liver cancer was Mongolia. For gallbladder cancer, Bolivia reported the highest ASIR and ASMR. By 2050, the annual number of new cases and deaths from liver cancer will increase to 1,564,034 (an 80.6 percent increase from the year 2022) and 1,420,926 (an 87.3 percent increase), respectively. The annual number of new cases and deaths from gallbladder cancer will increase to 235,096 (a 91.9 percent increase from the year 2022) and 176,725 (a 98.4 percent increase), respectively. Africa has the largest increase in both projected new cases and deaths from liver and gallbladder cancer globally in 2050. Conclusions: Inequities in liver and gallbladder disease burden persist worldwide. Regions such as Asia and Africa, as well as countries such as Mongolia and Bolivia, which face heavy disease burden and rising incidence rates, must prioritize the establishment of cancer control initiatives. Reference | Related Articles | Metrics

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Progress summary clinical trials of new drugs for liver cancer Sun Jiayang, Hu Wei, Tang Yu Electronic Journal of Liver Tumor    2024, 11 (4): 1-5.   Abstract （48）      PDF （1948KB）（16）       Knowledge map    Save Objective: To summarize the development trend of global clinical trials of primary hepatic cancer(HCC) from 2020 to June 2024. Methods: Based on the Trialtrove database developed by Informa Pharma Intelligence (London, UK), the clinical trials of liver cancer and the related medicines launched from 2020 to 2024 were extracted. The annual growth rate, the characteristics of trials and tested products were analyzed. Results: During the statistical period, a total of 356 clinical trials for HCC were carried out worldwide, accounting for 4.3% of all anti-cancer clinical trials. Among them, 189 (53.1%) were initiated by domestic companies. The number of clinical trials for HCC peaked in 2022 (101 trials). Phase I(including phase Ⅰ/Ⅱ) clinical trials were the most common trial phase type (266 trials, 74.7%). In terms of trial indications, drug development for advanced HCC accounted for the highest proportion (324 trials, 91.0%). Among all the investigational drugs, the types of drugs involved mainly included antibody drugs (48.0%), small molecule targeted drugs (25.4%), cell and gene therapy (15.4%) and antibody-drug conjugate (5.0%). Thirty-two clinical trials focused on first line treatment for late-stage HCC. Among them, the main investigational treatment modality was combined immunotherapy based on immune checkpoint inhibitors. A total of 262 clinical trials were conducted for patients with advanced HCC progressed after previous treatment, of which 32 trials (12.2%) were carried out in patients failed immunotherapy. All the 32 trials were in phase Ⅰ/Ⅱ trials, involving a variety of experimental drug types. Conclusions: The clinical development of liver cancer drugs is active in the world, and domestic enterprises play an important role. In liver cancer, immunotherapy is the most active field of drug development. While in the clinical trials including heavily treated HCC patients, cell and gene therapy is also an important clinical research area. It is suggested that domestic enterprises should increase investment in the development of novel drugs for liver cancer, explore more new targets and drugs with new mechanisms, and broaden the possible directions of liver cancer treatment. Reference | Related Articles | Metrics

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Efficacy and safety of lenvatinib in patients with hepatocellular carcinoma Zhou Jianguo, Wang Bingchen, Li Haocheng, Zhang Yuewei, Peng Tao, Liu Hongli, Xiang Xiaojun, Sun Chuandong, Liu Jun, Li Guangming, Li Dewei, Wang Yu, Cai Jianqiang Electronic Journal of Liver Tumor    2025, 12 (3): 1-6.   Abstract （48）      PDF （2070KB）（3）       Knowledge map    Save Objective: To evaluate the efficacy and safety of the comprehensive treatment regimen based on lenvatinib in patients with HCC. Methods: This study was a retrospective real-world study. A total of 1,000 HCC patients who received comprehensive treatment based on lenvatinib and were admitted to 13 research centers across the country from January 2022 to December 2024 were included. The basic clinical information of patients, treatment plans, laboratory indicators and survival outcomes were all collected and managed through standardized databases. The primary endpoint of the study was progression-free survival (PFS), and the secondary endpoints included the 1-year PFS rate, 1-year overall survival rate (OS), and safety analysis. Statistical analysis was conducted using Kaplan-Meier survival analysis and log-rank test to evaluate the differences in efficacy among different treatment strategies. Results: Among 1 000 patients, 83.70% were male, and the median age was 59.0 years (IQR: 52.0, 67.0). In the analysis of the combined disease history of the patients, the disease distribution showed significant differences: The proportion of history of hypertension was the highest (15.60%), followed by history of diabetes (5.80%), and liver cirrhosis (5.00%). The proportion of patients who had received surgical treatment in the past was 30.50%, the proportion of liver resection was 19.50%, and only 1.80% of the patients had received radiotherapy. The application rate of interventional therapy in the population of this study was 34.60%. The positive rate of hepatitis B virus surface antigen was 55.10% and the positive rate of anti-hepatitis C virus antibody was 3.80%. According to the Barcelona Clinic Liver Cancer(BCLC) staging, the proportion of patients in the advanced stage (BCLC-C, D stage) was 28.00%. In terms of treatment regimens, 79.80% of the patients received 8mg lenvatinib treatment, 60.7% of the patients received lenvatinib monotherapy, and 20.8% of the patients received combined immunotherapy. The therapeutic effect analysis showed that the median PFS of the overall patients was 7.0 months (95%CI: 7.0-8.0), and the 1-year OS rate was 97.00%(95%CI: 96.00%-98.00%). The 1-year PFS rate was 16.00%(95%CI: 14.00%-19.00%). The adverse events occurred rate was 23.60% during the follow-up period, and no serious adverse events were observed. Conclusion: The lenvatinib combination strategy has a positive impact on survival prognosis for HCC patients, but it still needs to be optimized for long-term disease control. Reference | Related Articles | Metrics

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Heat shock protein family A member 1A expression is increased in hepatocellular carcinoma and mediates sorafenib resistance Yang Li, Lu Xue Electronic Journal of Liver Tumor    2025, 12 (2): 14-21.   Abstract （46）      PDF （5456KB）（1）       Knowledge map    Save Objective: To explore the expression of heat shock protein family A member 1A (HSPA1A) in hepatocellular carcinoma (HCC) patients and whether it is involved in sorafenib resistance mechanism. Methods: The 152 patients with HCC admitted to our hospital from March 2022 to March 2024 were selected. Hub genes mediating sorafenib resistance were screened by three microarray data from the Gene Expression Omnibus database. Resistance genes were further explored by The Cancer Genomic Atlas-HCC cohort, immunohistochemistry (IHC), quantitative real-time polymerase chain reaction (RT-qPCR), western blot (WB) analyses, and cellular function. The correlation between HSPA1A expression and sorafenib 50% inhibitory concentration(IC50) was analysed by drug sensitivity. The relationship between HSPA1A expression and autophagy signalling was analysed by single-sample single sample gene set enrichment analysis (ssGSEA) algorithm. Results: HSPA1A expression was significantly higher in both sorafenib-treated and resistance tissues (P<0.05). IHC, RT-qPCR and WB confirmed that HSPA1A expression levels were higher in sorafenib-resistant patients than in responding patients (all P<0.05). Gene Expression Profiling Interactive Analysis database and IHC showed significantly higher HSPA1A protein expression in HCC tissues. Clinical cohorts and the Kaplan-Meier plotter database confirmed lower overall survival rate and relapse-free survival rate in patients with high HSPA1A expression (all P<0.05). CCK-8, clone formation, scratch and invasion assays confirmed that knockdown of HSPA1A significantly inhibited Huh-7 and MHCC97-L cell viability, proliferation, migration and invasion ability (all P<0.05).CCK-8 assay showed that the IC50 of sorafenib in Huh-7 and MHCC97-L cells knocked down by HSPA1A decreased by 17.4% and 19.3% (all P<0.05), increasing the therapeutic sensitivity of sorafenib. ssGSEA analysis showed that high HSPA1A mRNA expression inhibited autophagy activity (P<0.05). Conclusion: HSPA1A expression is increased in HCC and may be involved in the mechanism of sorafenib resistance, and the underlying mechanism may be related to autophagy signalling. Further experiments are needed to explore the potential mechanism of HSPA1A in HCC and provide new strategies to overcome sorafenib resistance. Reference | Related Articles | Metrics