Research into liver cancer

Researchers around the world are looking at better ways to prevent, diagnose and treat primary liver cancer.

If you are looking for a trial for liver cancer in the UK, go to Cancer Research UK’s clinical trials database. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of the type of research being carried out in liver cancer.

Research and clinical trials

All cancer treatments must be fully researched before they can be used for everyone. This is so we can be sure that:

• they work
• they work better than the treatments already available
• they are safe

Prevention

Research is going on all around the world looking at ways to prevent liver cancer developing.

Hepatitis B and C viruses can cause scarring of the liver (called cirrhosis). This can increase the risk of a type of liver cancer called hepatocellular carcinoma (HCC). Research has shown that the hepatitis B vaccine has reduced the number of liver cancers. This is particularly the case in countries where hepatitis B is common, such as Taiwan.

In the UK, children now have the hepatitis B vaccine as part of the childhood vaccination programme. And people at high risk of hepatitis B can also have the vaccine.

Researchers are currently developing a hepatitis C vaccine.

Screening

Screening means testing people for early stages of a disease before they have any symptoms. Diagnosing a cancer earlier may mean that treatment is more successful.

There is no national screening programme for liver cancer. But some people at high risk of developing it might have screening. This is usually done with an ultrasound scan. You may also have a blood test for a biomarker called AFP (alpha fetoprotein). Some people with HCC have a higher than normal level of AFP. But AFP can be raised for reasons other than cancer.

Researchers are looking for other biomarkers that may be more accurate in diagnosing liver cancer at an early stage.  Research has been promising so far, but more studies are needed to see how useful they are.

Surgery

Surgery gives the best chance of curing liver cancer. Some people cannot have surgery if the cancer has spread to other parts of the body. Or if they are not well enough to have surgery.

Surgeons are developing surgical techniques to make surgery safer and more effective. They aim to improve recovery and quality of life for people after surgery.

The traditional way of removing part of the liver is through a large cut in your tummy (abdomen). Another way is to make several small cuts in your tummy (abdomen). The surgeon removes the part of your liver with cancer through one of these cuts. This is called keyhole or laparoscopic surgery.

Researchers are comparing these two ways of doing surgery. They want to find out:

• if there is a difference in the length of recovery time
• how it affects your general well being 

Reducing the risk of cancer coming back after surgery

After surgery to remove the cancer, there is a risk that the cancer may come back (recurrence). The risk depends on different factors including what the tumour looks like under the microscope. And if cancer had started to grow into blood vessels of the liver.

For some types of cancers, you have a treatment such as surgery. Then you have another treatment to reduce the risk of recurrence. This is called adjuvant treatment. At the moment there are no standard adjuvant treatments for primary liver cancer.

Researchers in one trial want to find out if a drug called pembrolizumab will reduce this risk. Pembrolizumab is a type of immunotherapy. In this trial you have your main treatment which is either:

• surgery, or
• treatment using heat (thermal ablation)

Then you have pembrolizumab or a dummy tablet for about a year.

Immunotherapy and targeted cancer drugs

There are different types of targeted cancer drugs and immunotherapies. Researchers are studying the best way of having these drugs. And if it’s best to have them with other treatments for liver cancer. These drugs include:

• nivolumab (with another treatment called trans arterial chemoembolisation)
• pembrolizumab
• cabozantinib
• ramucirumab
• HMBD-001
• A2AFP (AFPc3321)

Cancer vaccines

Cancer vaccines are a type of immunotherapy. They help the immune system to recognise and attack cancer cells. One type of vaccine is made from dendritic cells. These are a type of white blood cell. Doctors in one trial (called ImmunoTACE) are looking at this type of vaccine for liver cancer. They want to find out whether it’s helpful to have this vaccine with chemotherapy and chemoembolisation.

Researchers have also looked at another vaccine called IMA970A with chemotherapy.