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Review article: delivering precision oncology in intermediate‐stage liver cancer
Author(s) -
Pinato D. J.,
Howell J.,
Ramaswami R.,
Sharma R.
Publication year - 2017
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.14066
Subject(s) - medicine , stage (stratigraphy) , hepatocellular carcinoma , precision oncology , oncology , population , clinical oncology , cancer , intensive care medicine , modalities , liver cancer , paleontology , social science , environmental health , sociology , biology
Summary Background Intermediate‐stage hepatocellular carcinoma ( HCC ), for which trans‐arterial chemoembolization ( TACE ) constitutes the standard of care, is a patient subgroup with significant heterogeneity in clinical outcome. Sources of variation relate to differences in tumour burden, hepatic reserve, ethnicity and treatment modalities. Increasing research efforts have been dedicated to minimise the clinical diversity of this patient population and enhance optimal provision of treatment. Aim To comprehensively review the diverse prognostic models that have been proposed to refine the prognostic prediction of patients with HCC undergoing TACE . Results A number of prognostic algorithms ( HAP , ART , ABCR score and many others) have shown potential to address the clinical heterogeneity characterising patients with intermediate‐stage HCC and facilitate early identification of patients with poor prognostic features in whom alternative treatments or best supportive care might be more appropriate than TACE . Conclusions While an improved characterisation of intermediate‐stage HCC is a highly important clinical aim, current evidence suggests that novel prognostic algorithms in this patient population may offer potential benefits but non‐negligible challenges in the provision of TACE . This review summarises the currently available evidence to facilitate the development of precision oncology in intermediate‐stage HCC .