Concepts in Development

The AGITG research development strategy and prioritisation framework outline the process by which concepts progress from embryonic ideas to funded trials. The concepts listed below have been identified as a research priority for AGITG by the Working Parties, Community Advisory Panel and Scientific Advisory Committee, and are currently seeking funds to commence the trial.

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TUMOUR: Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the main form of primary liver cancer and is increasing in Australia. The outcomes for HCC remain poor, with less than 1 in 5 people surviving beyond 5 years after diagnosis and ranks as the second most deadly cancer globally. The management of HCC is complex, particularly as the major risk factor for developing HCC is advanced scarring of the liver, termed cirrhosis. The current standard treatment for those with intermediate stage HCC who cannot have curative treatments is a radiological procedure called transarterial chemoembolization (TACE). TACE works by giving small doses of chemotherapy directly into liver cancers and simultaneously blocking the blood supply to the cancer. TACE has variable outcomes and cancer recurrence occurs in approximately 1 in 3 patients. Recently, a combination of two medications has improved outcomes in patients with advanced stage HCC. One of the medications is an immunotherapy drug (atezolizumab), where the patient’s own immune system is stimulated to attack liver cancer cells, and the other medication in the combination (bevacizumab) alters cancer bloods vessels.

Atezolizumab/bevacizumab has become the standard of care for advanced HCC, however, the use of this combination in intermediate stage HCC has not been studied. This study aims to find out if atezolizumab/bevacizumab treatment is better than TACE, which is the current standard of care for intermediate stage HCC.