Dr. Cheng on Tumor Heterogeneity in HCC and Challenges for Clinical Trials

Ann-Lii Cheng, MD, PhD, distinguished professor and director of the cancer center of National Taiwan University, discusses the challenges that tumor heterogeneity in hepatocellular carcinoma (HCC) pose for clinical trials.

In the past, tumor heterogeneity was not a large consideration for clinicians using molecularly targeted therapy in HCC, because driver mutations could not be identified. However, in the new era of immunotherapy, tumor heterogeneity presents a larger issue.

For the future of this landscape, researchers will not only need to understand heterogeneity in the cancer genome, but also heterogeneity among immune cells. New areas of research include identification of more specific T cells relevant to the treatment of HCC, as well as the mutation type that will be the responsive to immunotherapy.

In this new field of inquiry, it will be increasingly important to explore more specific biomarkers that can aid in patient selection and follow-up for both clinical trials and clinical management.

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