A first-line treatment is available that can prolong the survival of the sick, with benefits also for the quality of life. Often diagnosed late, HCC remains a big killer
An extra chance of cure di Prolong the survival of patients with the most common form of liver cancer, advanced or unresectable hepatocellular carcinoma who have not undergone previous systemic therapy. Are approximately 13 thousand new cases diagnosed in Italy in 2020, 9,100 of which were caused by hepatitis B and C viruses and the remainder by other liver diseases. Unfortunately, the neoplasm does not give clear and specific symptoms, so only 10% of cases are identified at an early stage when surgery can be decisive: for this reason the cure rates are still low e only a fifth of patients live five years after diagnosi The Italian Medicines Agency (Aifa) has recently approved the drug atezolizumab which, in combination with bevacizumabimproves overall and progression-free survival compared to the previous standard of care.
New care at the forefront
Aifa’s green light came in light of the results obtained in the (phase three) study IMbrave 150 on 501 adult patients which showed how the administration of atezolizumab and bevacizumab, after a follow-up period of 8.6 months, reduced the risk of death (overall survival of 42%). In addition, at a median follow-up of 15.6 months, the risk of death appears to be reduced by 34%), improving what was achieved with standard sorafenib therapy. Approval of the atezolizumab-bevacizumab combination represents a milestone in the treatment of hepatocellular carcinoma – he says Antonio Gasbarrini, Professor of Internal Medicine at the Catholic University of the Sacred Heart, Campus of Rome and director of the Department of Medical and Surgical Sciences of the Agostino Gemelli University Hospital Foundation IRCCS -. After more than 10 years of immobility, a first-line treatment is finally available, capable of prolonging the survival of patients with an inoperable neoplasm, particularly delicate because they also suffer from liver dysfunction. Median patient survival was 19.2 months, the longest ever reported in a phase three study in this malignancy. a big step forward.
Another important goal
An analysis conducted for the first time also on the benefits reported by patients in terms of quality of life, confirms the achievement of other important objectives. With the combination, in fact, the effects of the neoplasm are felt more slowly and the impact on work, on leisure time, on the ability to walk distances and on symptoms less. These are the best data obtained so far in the history of hepatocarcinoma therapy and are comforting in terms of manageability and tolerability with excellent results also on the quality of life of patients – underlines Fortunato Ciardiello, Professor of Medical Oncology and Vice Rector, Luigi Vanvitelli University of Campania -. The interaction between immunotherapy and anti-angiogenic therapy represents the new therapeutic standard in this category of patients.
Beware of these symptoms
Due to late diagnosis in the vast majority of cases, liver cancer is the fifth big killer, after lung, colorectal, breast and pancreas. If, especially in the early stages, it gives no signs of yes, when the disease spreads, however, symptoms such as pain in the upper abdomenwhich can also radiate to the back and shoulders, belly enlargement, loss of weight and appetite, nausea, vomiting, feeling full, tired, jaundice (i.e. the yellow color of the skin), dark urine and fever. These are signs that should not be overlooked, it is better to talk about them with a doctor. A number of causes (including: hepatitis B and C virus infections, alcohol abuse, genetic and autoimmune diseases, diabetes, obesity) can induce persistent liver damage: these chronic liver diseases often worsen over the years leading to cirrhosis liver disease, a severe disease that over time can predispose to the onset of carcinoma. Given the particular complexity of the disease, often diagnosed late, and which often presents comorbidities, it is important that patients with hepatocarcinoma are followed by a multidisciplinary team composed of specialists with different skills – he concludes Ivan Gardini, President of the EpaC Onlus Association -. The parallel intervention of gastroenterologists, oncologists, diagnostic and interventional surgeons and radiologists is needed in order to guide patients and family members towards structures with the best diagnostic and therapeutic paths.
July 8, 2022 (change July 8, 2022 | 18:18)
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