Dr Lorenza Rimassa
Associate Professor of Medical Oncology, Humanitas University and IRCCS Humanitas Research Hospital, Milan, Italy, International Liver Cancer Association
Dr David James Pinato
Clinical Senior Lecturer, Imperial College London and Consultant Medical Oncologist, International Liver Cancer Association
Treatment of cancer has recognised a true revolution in the past two decades. Those who treat liver tumours could not hope for a better time to shake up clinical practice.
For way too long and despite incessant efforts from clinicians, patients, universities, charities and industry – liver tumours have remained neglected orphans from the transformative changes that chemotherapy has lent to a wide variety of cancers including breast, lung and ovary.
Demonstrating the value of therapies
Hepatocellular cancer, the most common form of liver cancer, is tough to treat as it arises most frequently in a scarred liver. Demonstrating that drug therapy was worth pursuing in this highly untreatable cancer type took years and for over a decade we only had one drug to treat it.
At medical conferences and in the clinic, more and more we hear a word being pronounced. One that we desperately needed: choice. After years of failure, there are now an increasing number of drugs that are available to patients and a disease that would prove fatal in 3-6 months can be successfully managed for up to two years in patients who respond to treatment.
We have learnt over the years that hepatocellular cancer is often invisible to our own immune system and we have developed immunotherapy to remove the “invisibility cloak” that protects cancer from our own natural defences. The same approach is proving useful in bile duct cancers, a rarer form of liver cancer from which we have learnt that combining chemotherapy and immunotherapy may be the way forward.
New drugs can be expensive and may not benefit all, so a lot of work remains to be done to make anti-cancer therapy affordable, universal and truly personalised.
Offering treatment to those in need
As novel choices for treatment arise it becomes crucial that, as a society, we are able to offer these treatments to everyone who needs them and understand who has the best chance of responding to each type of therapy. New drugs can be expensive and may not benefit all, so a lot of work remains to be done to make anti-cancer therapy affordable, universal and truly personalised.
We are at a turning point for the treatment of this disease, we have new drugs and we will have more in the near future. By working all together with the ultimate goal of improving not only the prognosis but also the quality of life of our patients, we will finally be able to offer true hope for patients affected by liver cancer.