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Tumor biopsy and patient enrollment in clinical trials for advanced hepatocellular carcinoma

World Journal of Gastroenterology 2017年第13期23卷 2448-2452页

作者： Lorenza Rimassa maria Reig Giovanni Abbadessa Markus Peck-Radosavljevic William Harris Vittorina Zagonel Davide Pastorelli Elena Rota Caremoli Camillo Porta Nevena Damjanov Hitendra Patel Bruno Daniele maria lamar Brian Schwartz Terri Goldberg Armando Santoro Jordi Bruix Medical Oncology and Hematology Unit Humanitas Cancer CenterHumanitas Clinical and Research Center Barcelona Clinic Liver Cancer Group Liver UnitHospital ClinicUniversity of BarcelonaIDIBAPSCIBERehd Clinical Development Ar QuleInc Department of Gastroenterology HepatologyEndrocrinologyand NephrologyKlinikum Klagenfurt am Worthersee Department of Medicine Oncology DivisionUniversity of Washington School of Medicine Department of Clinical and Experimental Oncology Medical Oncology 1Veneto Institute of Oncology-IRCCS Department of Oncology Santa Maria del Prato Hospital Department of Oncology Papa Giovanni XXIII Hospital Department of Oncology Fondazione IRCCS Policlinico San Matteo Division of Gastrointestinal Oncology Abramson Cancer Center of the University of Pennsylvania Department of Medicine The University of Arizona Cancer Center Department of Oncology G.Rummo Hospital Clinical Development Daiichi Sankyo Medical Oncology and Hematology Unit Humanitas Cancer CenterHumanitas Clinical and Research CenterHumanitas University

Tumor biopsies may help to reliably distinguish hepatocellular carcinoma(HCC) from other tumors, mostly cholangiocarcinoma as well as to identify the patient populations who most benefit from target-driven HCC treatments, in order to improve the success rate of experimental therapies. Clarifying tumor biology may also lead to identify biomarkers with prognostic role and/or enabling to predict response or resistance to therapies. Recently, clinical trials have more efficiently included biomarker endpoints and increasingly collected tumor tissue from enrolled patients. Due to their frail status and sometimes fast-progressing disease, the performance status of patients with HCC progressing on first-line therapy can deteriorate quickly, preventing their enrollment in clinical trials. However, the challenge of identifying the proper patient at the proper time can be overcome by periodic inter-department meetings involving the key specialists taking care of HCC patients, and solid networks between research centers and referring institutions. An early planned biopsy would also facilitate timely inclusion of patients in biology-driven clinical trials. Ultimately, institution of multidisciplinary teams can optimize treatment choice, biopsy timing, and quick enrollment of patients in clinical trials, before their performance status deteriorates.

关键词： Liver neoplasms Biopsy Biomarkers Clinical trial Tumor

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