New Hope for Liver Cancer Patients

Study reveals drug combination can effectively tackle tumours

A discovery by Cancer Research UK-funded scientists in Scotland could finally offer hope to patients with a particularly hard to treat cancer.

Researchers found a new combination of drugs was able to almost completely eradicate hepatocellular carcinoma, the most common type of liver cancer.

Led by Professor Tom Bird of the University of Edinburgh and the Cancer Research UK Scotland Institute in Glasgow, the laboratory research focused on specific areas where genetic alterations can cause liver cancer to begin.

Cancer is often caused by a breakdown in DNA, our genetic blueprint, causing cells to grow in the wrong place or out of control.

This new study, published in Nature yesterday (Wednesday 19 February), was able to take these specific areas, where genetic instructions go wrong in people, and replicate them in mice creating genetic avatars which could be targeted with a range of treatments.

An existing cancer drug, commonly used to treat leukaemia and multiple sclerosis, was found by the team to be effective at targeting difficult to treat hepatocellular carcinoma tumours.

The drug, called cladribine, is from a group of drugs called antimetabolites. These interfere with DNA synthesis and stop the cancer cells in their tracks.

Funded by Cancer Research UK and Wellcome, the study found cladribine notably reduced the number of tumours but was most effective when combined with another drug called lenvatinib when almost all the tumours were completely eradicated.

Next steps would be to run a clinical trial over a period of years to confirm the results in liver patients over a long-term period.

Lead author on the study, Professor Tom Bird of the Cancer Research UK Scotland Institute and the Institute for Regeneration and Repair at the University of Edinburgh, said: “This exciting discovery provides new hope for the thousands of people living every day with a liver cancer diagnosis.

“Finding new and effective ways to combine and use treatments already approved for other cancers may be a faster way to achieve successful outcomes for future patients.

“Taking a precision approach to treatment by tailoring therapies to the particular types of tumours based upon their genetic alterations, has the potential to transform how we understand, and treat, cancer.”

There are around 6,600 new liver cancer cases in the UK every year, with around 630 in Scotland, and the number diagnosed is increasing.* Liver cancer incidence rates are also significantly higher in Scotland than the UK average.**

Less than half of those diagnosed with liver cancer in Scotland survive their disease for a year or more making finding new ways to tackle this disease vital.***

Survival across the UK varies, but in all cases, fewer than half of those diagnosed with liver cancer survive their disease for a year or more.****

Diagnosis of liver cancer is often late with many patients diagnosed only when already receiving treatment for existing diseases such as cirrhosis or fatty liver disease. Late diagnosis makes liver cancers hard to treat as, due to the function of the liver, the disease often responds poorly to chemotherapy drugs.

Cladribine helps to stimulate the body’s own immune system to clear tumours but had never been used for liver cancer before.

Cancer Research UK’s Science Engagement Lead, Dr Sam Godfrey, said: “We are delighted to have funded this exciting research which could lead to new treatments and improved outcomes for patients with liver cancer.

“Liver cancer is a difficult cancer problem – it’s the fastest rising cause of cancer death in the UK and it can be hard to diagnose it at an early stage when treatment can be more effective.

“That’s why research like this is so important – it lays the foundations for improved cancer treatment, driving us towards a time when no one fears cancer.”

This new research offers potential for broader and more complex treatment regimes, known as precision medicine, to treat patients for their individual liver cancers, improving their chances of successfully treating tumours.

This personalised medicine approach which aims to tailor treatments to specific patients is a growing area of cancer research.

John O’Donnell from Glasgow welcomed the new research. The 75-year-old was just about to leave for a three-month break in Spain when he was diagnosed with liver cancer two and a half years ago.

The retired health and safety manager was only referred for an ultrasound after a routine blood test for his type 2 diabetes showed an abnormality in his liver function.

John said: “They told me the GP had no real reason for referring me – I’m lucky she was so diligent as otherwise I would never have known.”

John was told he had an 8.5cm tumour on his liver and his hopes for his holiday, and his future, were put on hold.

He said: “The only advice my GP could give me was to get a power of attorney. I was told chemotherapy only has a 30 per cent chance of reducing liver cancer tumours and surgery wasn’t an option as the tumour was considered too big to operate.”

Fortunately, John who lives in Muirhead, was accepted onto a clinical trial for people with advanced liver cancer through the Cancer Research UK Experimental Cancer Medicines Unit led by Professor Jeff Evans.

After just a few months on a new immunotherapy drug combination, John’s tumour had reduced by 35 per cent and it’s now less than half the size with no change in a year.

John said: “I’m living with liver cancer and I feel perfectly well now treatment has finished.

“It was hard at times but I’m absolutely delighted with the result and I’m proud that I was able to contribute in a small way to helping find new ways to tackle liver cancer.

“There lots of exciting things happening in cancer research and I hear about it every time I am in for a check-up.

“I’ve been told that if the treatment I’m on stops working there are other options so I’m delighted to hear of new developments like this.”

John and his wife Jeanette, 73, celebrated their 50th wedding anniversary last year are now hoping to go on that holiday with a trip to France also planned soon.

He said: “I feel good, my wife has been a great support throughout, and the hospital said I can perhaps miss one check-up appointment so we can take that long holiday at last.”