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Review article: delivering precision oncology in intermediate-stage liver cancer

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Title: Review article: delivering precision oncology in intermediate-stage liver cancer
Authors: Pinato, DJ
Howell, J
Ramaswami, R
Sharma, R
Item Type: Journal Article
Abstract: 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.
Issue Date: 25-Apr-2017
Date of Acceptance: 6-Mar-2017
URI: http://hdl.handle.net/10044/1/49544
DOI: https://dx.doi.org/10.1111/apt.14066
ISSN: 0269-2813
Publisher: Wiley-Blackwell
Start Page: 1514
End Page: 1523
Journal / Book Title: Alimentary Pharmacology and Therapeutics
Volume: 45
Issue: 12
Copyright Statement: © 2017 John Wiley & Sons Ltd. This is a non-final version of an article published in final at http://onlinelibrary.wiley.com/doi/10.1111/apt.14066/abstract
Sponsor/Funder: The Academy of Medical Sciences
Funder's Grant Number: N/A
Keywords: Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Pharmacology & Pharmacy
UNRESECTABLE HEPATOCELLULAR-CARCINOMA
TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION
SEQUENTIAL TRANSARTERIAL CHEMOEMBOLIZATION
CLINICAL-PRACTICE GUIDELINES
C-REACTIVE PROTEIN
PREDICTS SURVIVAL
LYMPHOCYTE RATIO
ART SCORE
Y-90 RADIOEMBOLIZATION
PROGNOSTIC INDEX
1103 Clinical Sciences
1115 Pharmacology And Pharmaceutical Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



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