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Johns Hopkins researchers develop breakthrough urine test for liver cancer, increasing early detection rates by supplementing traditional AFP testing. A groundbreaking screening test for hepatocellular carcinoma (HCC), developed by Amy Kim, a hepatologist at Johns Hopkins, and her team, has demonstrated the potential to detect liver cancer at an earlier stage than the current standard-of-care. This novel diagnostic approach seeks to identify a subset of genetic biomarkers in urine associated with HCC, thereby supplementing the traditional combination of ultrasound and alpha-fetoprotein (AFP) blood testing. AFP tests have shown variable effectiveness with detection rates ranging between 40% and 90%, and a substantial number of liver cancer patients exhibit low AFP levels or misleadingly high levels due to liver disease, reducing the reliability of AFP as a singular biomarker. The study, conducted in collaboration with the Baruch S. Blumberg Institute and published in the British Journal of Cancer in 2022, analyzed samples from over 600 patients at high risk for liver disease across five medical centers. Kim’s team demonstrated that the combined use of urine circulating tumor DNA (ctDNA) testing and AFP increased detection sensitivity from 40% to 77% in early-stage liver cancer, and from 62% to 92% in the very early […]

The assessment of response to radiation-based therapies can be complicated by persistent or changing imaging features, and this field of study is still in active development even though imaging-based response assessment systems have been validated for the evaluation of response to ablative locoregional therapies. Research is still needed to address the shortcomings of current imaging criteria for evaluating tumor response to these novel techniques, despite the increased application of radiation-based local-regional therapies for the treatment of HCC following technological advancements and a better understanding of tumor biology.

The authors reasoned that stereotactic body radiation therapy (SBRT) followed by sorafenib would increase overall survival (OS) in advanced HCC compared to sorafenib alone, despite it being the standard of care. Despite immunotherapy replacing chemotherapy as the systemic norm after the trial’s enrollment period ended, the results were in. In the trial, 177 patients were randomly assigned to receive either sorafenib alone or SBRT followed by sorafenib. Prior to sorafenib administration, SBRT treatment markedly increased OS as well as the effectiveness of secondary goals like progression-free survival and time to progression.