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]]>Get the latest updates in the liver space with our HCC detection (HD) expert pack
Includes
- Highlights and a PDF copy of the latest APAC regional consensus for PIVKA-II and AFP in HCC
- APASL 2023 Congress Report
- Updates on future studies and patient cases
About 1 in 3 early hepatocellular carcinoma (HCC) patients
are missed with current standard of care 1
Ultrasound + AFP has only 63% sensitivity in detecting early stage HCC2
37% are missed
This means that 37% patients are missing out on potentially curative HCC treatment.
Download the free HD expert pack
The gaps in current standard of care
Ultrasound3
- Operator variability
- Poor performance in patients with fibrotic changes and fatty infiltration of the liver
- Difficult to perform on obese patients
- Difficult to detect small tumors (< 2cm)
- Limited capacity in public hospitals and rural settings
AFP3-5
Sensitivity and specificity depends on cut-off values used AFP can be elevated (false positive) in:
- Cirrhosis
- Active hepatitis
- Other types of tumors
AFP can be normal (false negative) in:
- Certain HCC patients have normal AFP throughout the entire disease course. This can be dependent on the etiology of the disease (e.g. high prevalence of AFP-negative in patients with fatty liver disease induced HCC)
- Small HCC tumors (<2cm)
PIVKA-II + AFP improves detection of early HCC with increased sensitivity compared to AFP alone
In the recent 2022 'Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region', experts agree that PIVKA-II, when combined with AFP, improves the detection of HCC, compared to either biomarker alone4.
Experts also agree that PIVKA-II is valuable in the detection of HCC in AFP-negative HCC patients4.
Many patients with HCC are AFP-negative (defined as AFP ≤20 ng/ml)
Almost Half (46%) of 1,158 patients with HCC were AFP-negative10
PIVKA-II can detect up to 76% of patients with AFP-negative HCC11
Sensitivity
Specificity
AUC
Hear from the regional experts
Hear from clinicians around APAC who have implemented PIVKA-II in their clinical practice, on their experience using PIVKA-II as an aid in the diagnosis of HCC.
Further resources
Want to learn more about HCC and liver disease? Explore the various resources available on Combating Cancer:
References:
- Hanouneh, I. A., Alkhouri, N., & Singal, A. G. (2019). Hepatocellular carcinoma surveillance in the 21st century: Saving lives or causing harm?. Clinical and molecular hepatology, 25(3), 264–269. https://doi.org/10.3350/cmh.2019.1001
- Tzartzeva, K., Obi, J., Rich, N. E., Parikh, N. D., Marrero, J. A., Yopp, A., Waljee, A. K., & Singal, A. G. (2018). Surveillance Imaging and Alpha Fetoprotein for Early Detection of Hepatocellular Carcinoma in Patients With Cirrhosis: A Meta-analysis. Gastroenterology, 154(6), 1706–1718.e1. https://doi.org/10.1053/j.gastro.2018.01.064
- Simmons, O., Fetzer, D. T., Yokoo, T., Marrero, J. A., Yopp, A., Kono, Y., Parikh, N. D., Browning, T., & Singal, A. G. (2017). Predictors of adequate ultrasound quality for hepatocellular carcinoma surveillance in patients with cirrhosis. Alimentary pharmacology & therapeutics, 45(1), 169–177. https://doi.org/10.1111/apt.13841
- Kim, D. Y., Toan, B. N., Tan, C. K., Hasan, I., Setiawan, L., Yu, M. L., Izumi, N., Huyen, N. N., Chow, P. K., Mohamed, R., Chan, S. L., Tanwandee, T., Lee, T. Y., Hai, T. T. N., Yang, T., Lee, W. C., & Chan, H. L. Y. (2023). Utility of combining PIVKA-II and AFP in the surveillance and monitoring of hepatocellular carcinoma in the Asia-Pacific region. Clinical and molecular hepatology, 29(2), 277–292. https://doi.org/10.3350/cmh.2022.0212
- Tokushige, K., Hyogo, H., Nakajima, T., Ono, M., Kawaguchi, T., Honda, K., Eguchi, Y., Nozaki, Y., Kawanaka, M., Tanaka, S., Imajo, K., Sumida, Y., Kamada, Y., Fujii, H., Suzuki, Y., Kogiso, T., Karino, Y., Munekage, K., Kuromatsu, R., Oeda, S., … Hashimoto, E. (2016). Hepatocellular carcinoma in Japanese patients with nonalcoholic fatty liver disease and alcoholic liver disease: multicenter survey. Journal of gastroenterology, 51(6), 586–596. https://doi.org/10.1007/s00535-015-1129-1
- Liebman, H. A., Furie, B. C., Tong, M. J., Blanchard, R. A., Lo, K. J., Lee, S. D., Coleman, M. S., & Furie, B. (1984). Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. The New England journal of medicine, 310(22), 1427–1431. https://doi.org/10.1056/NEJM198405313102204
- Ono, M., Ohta, H., Ohhira, M., Sekiya, C., & Namiki, M. (1990). Measurement of immunoreactive prothrombin precursor and vitamin-K-dependent gamma-carboxylation in human hepatocellular carcinoma tissues: decreased carboxylation of prothrombin precursor as a cause of des-gamma-carboxyprothrombin synthesis. Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine, 11(6), 319–326. https://doi.org/10.1159/000217667
- Chen, H., Chen, S., Li, S., Chen, Z., Zhu, X., Dai, M., Kong, L., Lv, X., Huang, Z., & Qin, X. (2017). Combining des-gamma-carboxyprothrombin and alpha-fetoprotein for hepatocellular carcinoma diagnosing: an update meta-analysis and validation study. Oncotarget, 8(52), 90390–90401. https://doi.org/10.18632/oncotarget.20153
- Xu, F., Zhang, L., He, W., Song, D., Ji, X., & Shao, J. (2021). The Diagnostic Value of Serum PIVKA-II Alone or in Combination with AFP in Chinese Hepatocellular Carcinoma Patients. Disease markers, 2021, 8868370. https://doi.org/10.1155/2021/8868370
- Farinati, F., Marino, D., De Giorgio, M., Baldan, A., Cantarini, M., Cursaro, C., Rapaccini, G., Del Poggio, P., Di Nolfo, M. A., Benvegnù, L., Zoli, M., Borzio, F., Bernardi, M., & Trevisani, F. (2006). Diagnostic and prognostic role of alpha-fetoprotein in hepatocellular carcinoma: both or neither?. The American journal of gastroenterology, 101(3), 524–532. https://doi.org/10.1111/j.1572-0241.2006.00443.x
- Ji, J., Wang, H., Li, Y., Zheng, L., Yin, Y., Zou, Z., Zhou, F., Zhou, W., Shen, F., & Gao, C. (2016). Diagnostic Evaluation of Des-Gamma-Carboxy Prothrombin versus α-Fetoprotein for Hepatitis B Virus-Related Hepatocellular Carcinoma in China: A Large-Scale, Multicentre Study. PloS one, 11(4), e0153227. https://doi.org/10.1371/journal.pone.0153227
The post Get the latest updates in the liver space with our HCC detection (HD) expert pack appeared first on Clinical Value of Diagnostics.
]]>The post Expert Consensus Recommendations on Biomarker Testing in Metastatic and Non metastatic NSCLC in Asia appeared first on Clinical Value of Diagnostics.
]]>Quick Summary
Most published guidelines for genomic biomarker testing in NSCLC reflect the disease epidemiology and treatments readily available in Europe and North America. Nevertheless, 60% of annual global NSCLC cases occur in Asia, where patient characteristics, tumor molecular profiles, and treatments vary greatly from the Western world. For example, mutations in the EGFR occur at a higher prevalence in Asia than in other world regions. Although medical associations such as the International Association for the Study of Lung Cancer, European Society for Medical Oncology, and American Society of Clinical Oncology have described principles for tumor genomic biomarker testing in NSCLC, there is a need for recommendations specific for Asia.
This report provides consensus recommendations for NSCLC biomarker testing from Asian lung cancer experts for clinicians working in Asia to improve patient care. Biomarker testing approaches for actionable genetic alterations in EGFR, ALK, ROS1, and others are discussed for nonmetastatic and metastatic forms of adenocarcinoma and squamous cell carcinoma.
The post Expert Consensus Recommendations on Biomarker Testing in Metastatic and Non metastatic NSCLC in Asia appeared first on Clinical Value of Diagnostics.
]]>The post Recommendations for the Use of Next-Generation Sequencing and the Molecular Tumor Board for Patients with Advanced Cancer: A Report from KSMO and KCSG Precision Medicine Networking Group appeared first on Clinical Value of Diagnostics.
]]>Quick Summary
Next-generation sequencing (NGS) is becoming essential in the fields of precision oncology. With implementation of NGS in daily clinics, the needs for continued education, facilitated interpretation of NGS results and optimal treatment delivery based on NGS results have been addressed. Molecular tumor board (MTB) is a multidisciplinary approach to keep pace with the growing knowledge of complex molecular alterations in patients with advanced solid cancer. The purpose of these recommendations is to:
- provide an opportunity to share relevant clinical insights and experience among experts through the treatment guidelines development process
- suggest a systematic process to oncology experts when conducting NGS tests, interpreting results, and making relevant therapeutic decisions
- help determine the optimal treatment strategies through multidisciplinary approaches by suggesting the effective operation of the MTB.
The post Recommendations for the Use of Next-Generation Sequencing and the Molecular Tumor Board for Patients with Advanced Cancer: A Report from KSMO and KCSG Precision Medicine Networking Group appeared first on Clinical Value of Diagnostics.
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