Interviews with APAC liver disease
experts reveal 7 priorities for implementing HCC surveillance programs

Quick Summary

HCC is a leading cause of cancer mortality in Asia. Causes of HCC include viral hepatitis B and C infections, with recent increases in metabolic disorders, such as NAFLD, also playing a factor.

Early HCC interventions are highly effective and can lead to improved patient outcomes and survival. Therefore, HCC surveillance programs are pivotal in detecting HCC early and making the appropriate interventions.

In this whitepaper, HCC surveillance programs in Asia were analysed. The learnings from well established HCC surveillance programs in Asia, as well as the challenges in areas that have not implemented such programs have highlighted 7 priorities for implementing an HCC surveillance program:

Include HCC surveillance in national program and strategic plans

HCC surveillance programs should be fit into the national health strategy where appropriate, taking into account the local incidence and prevelance rates, and existing priorities and resources.

Secure sustainable funding commitments

Long-term resourcing and financing is key to making HCC survaillance programs successful. The current health financign system in the area, and ability to pay should be assessed, while exploring various funding methods such as centralised healthcare coverage or private insurance.

Collect, analyse, and utilise data to inform program design

The development of HCC surveillance program should be based on data, such as HCC epidemiology, patient outcomes, human and economic cost of HCC. These data should be collected and analysed.

Adopt optimal technologies to advance HCC surveillance

Technology can help to improve access to HCC surveillance programs, as well as improve patient outcomes by detecting HCC early. Some examples include: including additional biomarkers such as PIVKA-II, using biomarker based digital algorithms and diagnostic models, using more advanced imaging techniques, and adapting IT systems to support surveillance programs.

Mobilise existing resources for HCC surveillance

Tapping on exisiting resources to expand capacity for HCC care and surveillance., For example increasing the range of HCPs who can diagnose and manage HCC like primary and community HCPs, expanding private healthcare capacity in HCC care.

Engage a broad spectrum of stakeholders to further surveillance goals

Governmental decision-makers, physicians, patients and PAGs, payers and industry need to come together to drive implementation of a robust HCC surveillance programs that address needs of all stakeholders.

Raise awareness and provide education on the need for HCC suveillance

Raising the knowledge among the general population and HCPs on HCC and the importance of surveillance can improve uptake and compliance to surveillance programs.

Recommendations to ensure NGS standardisation & quality, based on roundtable discussions with experts in oncololgy, pathology, policy makers, and industry experts

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The advancement of technology has created more opportunities for Next-Generation Sequencing (NGS). With greater public interest in Precision Medicine, it seems hopeful that NGS can potentially change the paradigm in oncology diagnostics and treatment decision-making.

To realise the potential of NGS, different stakeholders should work together to establish more effective and market-appropriate national policy strategies. These strategies should focus on reinforcing the value of quality NGS as well as ensuring the need for quality assurance and standardisation.

In this paper, the authors share their recommendations on ensuring standardisation and quality NGS across the region.

National Comprehensive Cancer Network NSCLC and SCLC guideline recommendations for cancer care decision-making

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The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) document evidence-based, consensus-driven management to ensure that all patients receive preventive, diagnostic, treatment, and supportive services that are most likely to lead to optimal outcomes.

The NCCN Guidelines are a comprehensive set of guidelines detailing the sequential management decisions and interventions to assist in the decision-making process of individuals involved in cancer care (including physicians, nurses, pharmacists, payers, patients and their families), with the ultimate goal of improving patient care and outcomes.

The NCCN Guidelines provide recommendations based on the best evidence available at the time they are derived, and are continuously updated and revised to reflect new data and clinical information that may add to or alter current clinical practice standards.

Read the latest NCCN lung cancer guidelines below:

Quick Summary

Biomarkers are biological molecules found in blood, other body fluids or tissues that can indicate a normal or abnormal process, condition, or disease. They play an important role in the clinical management of cancer patients by facilitating risk stratification, early detection, diagnosis, and prediction of prognosis or treatment response. In hepatocellular carcinoma (HCC), there is a need for better biomarkers to stratify patients at different stages of clinical management. Guidelines such as the Tumor Marker Utility Grading System (TMGUS) and the Reporting recommendations for tumor marker prognostic studies (REMARK) provide useful frameworks for biomarker development and validation in cancer. However, modifications may be required for specific clinical scenarios, such as risk stratification and treatment response assessment in HCC. To address these issues, the International Liver Cancer Association has assembled a group of experts on biomarker development to provide a framework on best practices for biomarker studies in HCC.

Authors: Amit G. Singal, Yujin Hoshida, David J. Pinato, Jorge Marrero, Jean-Charles Nault, Valerie Paradis, Nabihah Tayob, Morris Sherman, Young Suk Lim, Ziding Feng, Anna S. Lok, Jo Ann Rinaudo, Sudhir Srivastava, Josep Llovet, Augusto Villanueva