Prof Ming-Lung Yu shares his clinical experience using PIVKA-II to complement AFP & ultrasound for early HCC detection

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Interview transcript:

Introduction

Hello everyone, I am Dr. Ming-Lung Yu. Currently I am a physician and Chair Professor of Hepatology at the Kaohsiung Medical University Hospital and Senior Vice President of National Sun Yat-sen University.

What is the unmet need in HCC surveillance and diagnosis?

There are about 11,000 new liver cancer patients in Taiwan every year. Unfortunately, 60% of liver cancers are advanced stage at the time of first diagnosis, and usually, the effect of treatment is not satisfactory. Patients with early-stage tumors, that can be removed surgically or by ablation, have the best chance of long-term survival. Therefore, early detections of liver cancers are crucial to increase patient outcome.

What is your current HCC surveillance practice and how is PIVKA-II implemented?

Ultrasound sonography is the most important and reliable screening tool, but its sensitivity will be affected by the size and location of nodules, operation technique, fatty liver, etc. Therefore, it needs serum biomarkers as an assistant tool. AFP has been used commonly in liver cancer diagnosis now. And PIVKA-II has been used more and more in daily practice recently since it became the reimbursed item.

Why was PIVKA-II implemented in your clinical practice?

There is cumulating evidence supporting the application of PIVKA-II for HCC diagnosis. And PIVKA-II combined with AFP and ultrasound sonography can improve the sensitivity of HCC surveillance, especially in early stage of HCC.

What is your clinical experience using PIVKA-II and how effective is it in your clinical practice in HCC surveillance and diagnosis?

We observed that PIVKA-II has good sensitivity & specificity in HCC patients, and it could be better when combined with AFP & ultrasound sonography.

For BCLC stage 0/A patients, we found PIVKA-II has the best sensitivity, compared to those of ultrasound sonography and AFP.

For example, some HCC patients have no liver nodules in ultrasound sonography and with normal AFP, but have increased levels of PIVKA-II and are further confirmed by CT/MRI. Obviously, PIVKA-II is very helpful for these patient population.

How has PIVKA-II aided in your clinical decision making?

PIVKA-II can help us to have one more useful tool for improving the early diagnosis of liver cancers.

The views and opinions expressed by Prof. Ming-Lung Yu are his own views and opinions. Roche disclaims all liability in relation to these views and opinions.