Hepatitis C virus is a major cause of hepatocellular carcinoma (HCC) worldwide, especially in the Western World. Monday’s Hepatobiliary Neoplasia Special Interest Group Program, “HCV Therapy and HCC” will review mechanistic and clinical information relevant to HCC occurring in hepatitis C virus, and will address up-to-date clinical questions regarding hepatitis C virus treatment in this context.
“We are in a new era of information about hepatitis C and HCC and there is a little bit of uncertainty about regarding hepatitis C virus in this setting,” said Program Chair Gregory J. Gores, MD, FAASLD, a hepatologist at Mayo Clinic, Rochester, Minn. “With this symposium we can get experts from across the world to give insight into relevant concepts including whether these new drugs prevent cancer if you have hepatitis C, and if you already have hepatitis C and cancer, do they make the cancer worse.”
During Session I of the symposium, Hashem B. El-Serag, MD, MPH, Professor of Medicine-Gastroenterology at Baylor College of Medicine, will provide a historical perspective on the use of interferon era to treat hepatitis C.
“Before, if you got hepatitis C and got treated with interferon and had a response, most agreed that a sustained virologic remission decreased the risk for developing liver cancer,” Dr. Gores said. “That interferon era is history now though. It wasn’t particularly effective and was a toxic regimen.”
Nathalie Ganne-Carrie, MD, PhD, Hôpital Jean Verdier, Bondy, France, will update attendees on the advent of the directing acting antiviral (DAA) era. This presentation will look at how effectively these new drugs treat hepatitis C and whether they lower the risk for developing liver cancer, Dr. Gores said.
Michael D. Leise, MD, Associate Professor of Medicine at Mayo Clinic, will take on the more controversial topic of whether DAA therapies increase the risk of HCC recurrence following liver transplantation performed for HCC.
“If you treat somebody who has liver cancer while waiting for transplantation you may be predisposing that person to developing recurrent liver cancer following transplant,” Dr. Gores said.
Session II will further discuss whether DAA for hepatitis C increase HCC recurrence. Maria Elisa Reig, MD, PhD, of Hospital Clinic Barcelona, University of Barcelona, and Amit G. Singal, MD, MS, Associate Professor of Internal Medicine at UT Southwestern Medical Center, will each present opposing viewpoints on this important question.
Laura M. Kulik, MD, Professor of Medicine at Feinberg School of Medicine at Northwestern, will wrap up the final session by taking much of the information presented and boiling it down to guide providers on whether patients with early stage HCC and hepatitis C should receive concomitant therapy.
According to Dr. Gores, attendees will not be able to get this amount of information on hepatitis C and HCC anywhere else.
“This will be exciting because it is on the very edge of our knowledge about these conditions and new therapies,” Dr. Gores said. “This is an important patient population and attendees will not be able to see these data in their richness, complexity, and balance in such a short period of time anywhere else.”