Generic chemoprevention of hepatocellular carcinoma

Research output: Contribution to journalReview article

Abstract

Chronic fibrotic liver disease caused by viral or metabolic etiologies is a high-risk condition for developing hepatocellular carcinoma (HCC). Even after curative treatment of early-stage HCC tumor, the carcinogenic microenvironment persists in the remnant diseased liver and supports the development of de novo HCC tumors (de novo HCC recurrence). Therefore, prevention of HCC development in patients at risk of not only first-primary but also second-primary HCC tumors is theoretically the most impactful strategy to improve patient prognosis. However, no such therapy has been established to date. One major challenge is the identification of clinically relevant targets that can be achieved by utilizing the reverse-engineering strategy of chemoprevention discovery, which integrates omics information from clinical cohorts with completed follow-up for cancer development. Clinical and experimental studies have suggested etiology-specific and generic candidate HCC chemoprevention strategies, including statins, antidiabetic drugs, selective molecular targeted agents, and dietary and nutritional substances. Clinical testing of the candidate compounds can be cost-effectively performed by combining it with HCC risk biomarker evaluation to specify the target patient population most likely to benefit from the therapy. Nontoxic, generic agents will have broad clinical applicability across the diverse HCC etiologies and clinical contexts and are expected to substantially improve the still dismal prognosis of HCC.

Original languageEnglish (US)
Pages (from-to)23-35
Number of pages13
JournalAnnals of the New York Academy of Sciences
Volume1440
Issue number1
DOIs
StatePublished - Mar 2019

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Chemoprevention
Tumors
Hepatocellular Carcinoma
Liver
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Reverse engineering
Biomarkers
Hypoglycemic Agents
Testing
Liver Diseases
Costs
Neoplasms
Tumor Microenvironment
Health Services Needs and Demand
Etiology
Therapeutics
Costs and Cost Analysis
Recurrence
Therapy

Keywords

  • chemoprevention
  • cirrhosis
  • hepatocellular carcinoma
  • precision medicine
  • recurrence

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

Cite this

Generic chemoprevention of hepatocellular carcinoma. / Athuluri-Divakar, Sai Krishna; Hoshida, Yujin.

In: Annals of the New York Academy of Sciences, Vol. 1440, No. 1, 03.2019, p. 23-35.

Research output: Contribution to journalReview article

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