Michael R. Charlton, MD, MBBS, professor of medicine, director, Center for Liver Diseases, and co-director, Transplant Institute, University of Chicago Medicine, discusses the interaction between liver disease and hepatocellular carcinoma (HCC).

In recent years, the patient population that requires liver transplantation has changed, says Charlton. Historically, the most common reason for a liver transplant was hepatitis C, Charlton says. However, the incidence in hepatitis C infections, as well as liver cancer arising from hepatitis C infections, has decreased, Charlton explains.

Notably, the incidence of nonalcoholic fatty liver disease and alcohol-related liver disease has risen, particularly during the COVID-19 pandemic, says Charlton. As a result, HCC cases are also rising and these are likely to continue rising over time, Charlton explains.

However, the synergy between nonalcoholic fatty liver disease or alcohol-related liver disease and HCC informs the likelihood of a patient developing liver failure and requiring a liver transplant, says Charlton. As such, the HCC paradigm will likely need to move toward more personalized treatment approached for individuals with liver disease, concludes Charlton.

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Michael R. Charlton, MD, MBBS, discusses the interaction between liver disease and hepatocellular carcinoma. 



Dr. Charlton on the Interaction Between Liver Disease and HCC

Michael R. Charlton, MD, MBBS, professor of medicine, director, Center for Liver Diseases, and co-director, Transplant Institute, University of Chicago Medicine, discusses the effects of the COVID-19 pandemic on hepatocellular carcinoma (HCC).

At the beginning of the COVID-19 pandemic, going into the hospital was reserved for patients who required immediate care and essential staff, says Charlton. Now, more than a year since the start of the pandemic, the hospital setting is functioning as normal, Charlton explains.

However, at the height of the pandemic, many individuals were not comfortable coming into the hospital for HCC screening or did not go to the emergency room for potential HCC-related symptoms, Charlton explains. As such, it is likely that an increased number of patients will present with later-stage HCC, Charlton says. Moreover, these patients will require treatment with immunotherapy or systemic therapy vs curative-intent options, concludes Charlton. 

Michael R. Charlton, MD, MBBS, discusses the effects of the COVID-19 pandemic on hepatocellular carcinoma. 



Dr. Charlton on the Effects of the COVID-19 Pandemic on HCC 

Michael R. Charlton, MD, MBBS, professor of medicine, director of the Center for Liver Diseases, and co-director of the Transplant Institute at the University of Chicago Medicine, discusses the emergence of biomarkers in hepatocellular carcinoma (HCC).

A few years ago, Charlton believed the role of biopsies in HCC was diminishing, but with the emergence of biomarkers in the disease, his stance has changed. A presentation at the 2020 HCC-TAG Conference discussed different biomarkers in HCC and how the behavior of cells within a patient’s liver can help direct therapy at initial diagnosis or recurrence.

Research on biomarkers in HCC needs to continue; moreover, preliminary data indicate that biomarkers have meaning in the disease, according to Charlton. Retrospective data showed that falling transforming growth factor—ß levels during therapy was an important sign of response, says Charlton. The future of HCC treatment may shift based on biomarker findings and move more toward a personalized medicine approach moving forward, concludes Charlton.

Michael R. Charlton, MD, MBBS, discusses the emergence of biomarkers in hepatocellular carcinoma.

Michael R. Charlton, MD, MBBS

Articles

Dr. Charlton on the Interaction Between Liver Disease and HCC

Dr. Charlton on the Effects of the COVID-19 Pandemic on HCC

Dr. Charlton on the Emergence of Biomarkers in HCC