Liver cancer: non-invasive treatment trial to begin soon

A new non-invasive treatment for inoperable early-stage liver cancer is set to be trialled across Australia this year.

The trial led by Professor Alan Wigg from Flinders University’s College of Medicine and Public Health aims to test stereotactic ablative body radiotherapy (SABR), a non-invasive technique that enables precise delivery of high radiation doses.

Currently, the standard of care for hepatocellular carcinoma (HCC), the most common type of liver cancer, is treatment with percutaneous ablation, a thermal ablation treatment that is delivered directly into the tumour using a needle.

“Studies have shown the current standard of care is not always successful, with the cancer likely to re-occur in over 30% of cases, and a number of people being unable to access the treatment in the first place, due to the size and position of the tumour,” Professor Wigg said.

Stereotactic ablative body radiotherapy is a relatively new radiation technique that has already been used successfully to treat a number of other cancers, but it is not yet widely used to treat cancers of the liver, he said.

“It is delivered non-invasively by targeting the tumour with a number of radiation beams from different angles, allowing delivery of high dose and precise treatment across three to five sessions and reducing the damage to surrounding healthy tissue.”

The project, a collaboration between leading hepatologists, radiation oncologists and radiologists across 16 major Australian liver centres, will perform a randomised controlled trial to compare the non-invasive treatment against the current invasive standard of care, with the potential for the results to shift treatment protocols globally.

“Currently, SBRT is considered experimental and only used once first line treatments have failed,” Professor Wigg said.

“However, preliminary research has shown that the treatment has the potential to control tumours with very few adverse events and can reach those that would not be treatable with percutaneous ablation, due to a tumour’s size or difficult location.”

The researchers say with increasing rates of liver cancer across Australia, it’s vital that the best treatment is proven and applied.

“Rates of hepatocellular carcinoma have increased 378% in the last 30 years, the second largest increase of any cancer type, while its mortality rate has had the largest increase of any cancer,” Professor Wigg said.

“HCC is the only low survival cancer with a rapidly increasing incidence, so it’s vital we find ways to improve outcomes for patients.

“SABR can improve tumour control while at the same time its ability to be delivered in outpatient settings across fewer treatment sessions means it is also likely to be cost-effective and able to be rapidly adopted into clinical practice.”

The 5-year trial, funded by the Medical Research Future Fund’s Rare Cancers, Rare Diseases and Unmet Need Grant Opportunity scheme, will begin this year with trial sites anticipated in all major states of Australia.

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