A webinar presented by the Global Liver Institute highlighted areas of improvement needed in research for liver cancer, but also left listeners with hope for future treatments focused on strengthening immunity.
A webinar hosted by the Global Liver Institute Tuesday titled, “Needs and Challenges of Innovating and Advancing Research in Liver Cancers” featured 3 panelists who touched on successes and triumphs in liver cancer research, and where the research community needs to go from here.
Panelists included Ahmed O Kaseb, MD, professor, program director of hepatocellular carcinoma and the department of gastroentestinal medical oncology at University of Texas MD Anderson Cancer Center, Mark A McNiven, PhD, consultant for the division of gastroenterology and hepatology and the department of internal medicine, director of the Center for Biomedical Discovery at the Mayo Clinic, and Bruno Sangro, MD, of Clinica Universidad De Navarra in Spain, head of the hepatology unit and internal medicine specialist.
The moderator of this webinar was Sarah Manes, program director of the liver cancers department at Global Liver Institute.
First, the discussion started off with the panelists speaking on their roles and involvement in research projects, the type of research being conducted, and what their projects want to achieve.
Kaseb kicked off the initial answer by describing the multidisciplinary approach of MD Anderson Cancer Center where various teams work together to help patients in the clinic and in terms of conducting research. He said that this allows him to introduce research to the patient and include them in clinical trials, illustrating how the multidisciplinary approach and clinical activities and research ultimately benefit patients.
Sangro then explained his role in both research that has an immediate benefit for patients through collaborations with drugs and therapies, as well as translational research where samples are collected. Sangro works with the Specialized Programs of Research Excellence (SPORE) program, which was created by the National Cancer Institute and serves to "promote interdisciplinary research and to help basic research findings move quickly from the laboratory to the patient." Sangro and his team collaborate to promote knowledge that can lead to better therapies in the coming years.
“Just to backup 5 or 6 years, when we got involved with SPORE, we noticed that, despite the fact that liver cancers are on the rise and will become the second leading cause of cancer deaths within the next 5 years or so, of the 30 to 40 different SPORE programs, there were none focused solely on hepatic biliary cancers,” added McNiven.
Designing clinical trials with hematologists and scientists for specific risk factors in hopes of preventing underlying disease is also a goal of clinical trials, continued Kaseb.
“If we do research on the process that leads to cancer, we may find ways of preventing it, which will be very beneficial,” Sangro emphasized.
Manes then presented a question to the panelists on gaps in research results and the marginalization of certain communities.
Kaseb was the first to answer by saying that barriers such as patients with different cultural backgrounds, different levels of health care access, insurance, and cultural understanding of clinical trials exist in the treatment of liver cancer.
He continued by highlighting that his experience in medical school and medical training did not prepare him to understand cultural differences and barriers to inclusion in medical trials, not just because of access to insurance and health care, but also in patient understanding of clinical trials.
Sangro continued, saying that more community education on the relevance of medical research is needed, and that it is “the only way to move forward.”
McNiven was able to pinpoint 2 ways in which research trials have unintentionally excluded minority population: the first was that liver cancer studies have tended to focus on white males, and the other is insurance accessibility.
Furthermore, he highlighted the need for trust in diverse communities, and that the barrier of stigma persists in the treatment of liver cancer, such as perceiving that someone damaged their liver through intravenous drug use or alcohol abuse.
“Stigma is behind delayed diagnosis, more difficult access to care, etc. But [it] also impacts on funding. I'm sure if you plot the different tumor types and the number of funding activities, non-governmental funding activities, you'll see liver is at the bottom and the stigma around liver diseases in general,” elaborated Sangro.
Also, in speaking to the panel, McNiven said that a diverse workforce and diverse scientists, nurses, and physicians that interact which such communities can better represent those individuals and hopefully help those community members “feel more comfortable towards our interactions,” explained McNiven.
Finally, the panelists ended with a conversation on the future of improvements of liver cancer. Sangro specifically highlighted the power of the immune system in liver cancer:
“I think what we have learned over the last decade is that building upon the strength of the immune system gives us the opportunity because this is just the beginning. Immune checkpoint inhibitors, the drugs we now use, [are] just one form of enabling the immune system to fight against cancer. And I'm sure the next decade [we’ll] see a bloom in immune therapies other than immune checkpoint inhibitors.”
Sangro concluded the discussion with strong hope for the future of liver cancer.
Kaseb A, McNivens M, Sangro B. Needs and challenges of innovating and advancing research in liver cancers. Global Liver Institute. June 27, 2023. Accessed June 27, 2023. https://globalliver.org/new-leadership-and-new-understanding-in-the-cancer-world/