Management of hepatocellular carcinoma: time to be resilient


European Association for the Study of the Liver Hepatocellular Carcinoma Summit

13–14 February 2014, Geneva, Switzerland

Following on from the publication of clinical practice guidelines [1], the European Association for the Study of the Liver (EASL) organized a 2-day conference focused on the management of hepatocellular carcinoma (HCC). Over 700 delegates convened in Geneva in mid-February 2014. This report selects a few important points that were discussed at the meeting.

In comparison to other tumors, where the use of biomarkers has become routine in guiding clinical practice, none of them are used in HCC and the field is lagging behind. Several groups have published molecular classifications of HCCs, which are informative, and help us better understand the biology of HCC. Fortunately, different groups, using different samples, have identified the same HCC classes. The two common classes are characterized by:

• Mutations of β-catenin;

• Phosphorylation of the IGF receptor, phosphorylation of AKT, and mTOR activation.

The latter can be further divided into two subclasses, one coming from progenitor cells (high alpha-fetoprotein [AFP] at early stage), and the other, characterized by the activation of Wnt/TGF-β [2]. In terms of prognosis, the recurrence of HCC can be predicted by a five-gene tumor signature and a 186-gene genetic signature derived from adjacent nontumor tissue [3].

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