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Vol 23, No. 12, December 2019   |   Issue PDF view/purchase
Discovering possible treatments for liver cancer
Duke-NUS researchers discover that a specific subset of liver cells can turn into cancer cells and develop into hepatocellular carcinoma. This finding can aid in discovering strategies for effective diagnosis and treatment.

Researchers from Duke-NUS Medical School have found that a specific subset of self-regenerating liver cells can turn into cancer cells, which can then lead to the development of hepatocellular carcinoma (HCC), the most common form of liver cancer. Liver cancer is the second leading cause of cancer mortality. With more in-depth research about the development of liver cancer from self-regenerating liver cells, researchers are confident that they will be able to find more effective treatment methods to treat this deadly cancer, as well as to improve early diagnosis and classification of cancer subtypes.

In the world today, there are very few treatment options for liver cancer. A few examples would be chemotherapy, targeted cancer therapy (using drugs such as sorafenib and lenvatinib to block the growth and spread of cancer by interfering with specific molecules involved in cancer growth and development), surgery, tumour ablation and radiotherapy. However, despite being the most effective treatment option, surgery is not possible for those who are diagnosed at the later stages of liver cancer as the cancer may have spread to other organs or the size or location of the tumour makes surgery life-threatening. Also, as the diagnosis of liver cancer (or HCC) is often delayed, many patients are ineligible for surgical therapy and have to depend on drugs sorafenib and lenvatinib for targeted cancer therapy treatment instead. However, these drugs do little to improve the patients’ condition, making liver cancer the second leading cause of cancer mortality with poor prognosis.

Thus, researchers are keen to conduct more in-depth research on the development process of liver cancer from self-regenerating liver cells are needed to aid in the reduction of liver cancer mortality rates.

“In order to cure liver cancer, it is important to identify which subgroup of liver cells are being transformed into tumour cells. It is challenging, however, to detect the specific liver cells that undergo this transformation. The findings of this study have provided an important insight into the population of cells that may serve as the origin in HCC,” said Dr Ang Chow Hiang, Researcher from Duke-NUS Cancer and Stem Cell Biology Programme and lead author of the study. “

In lieu of that, the researchers at Duke-NUS Medical School came up with a highly complex method called “genetic lineage tracing” to find out whether these cells would become cancer cells when injuries to the liver last for a long period of time. The researchers at Duke-NUS Medical School were then able to use this method to find out what happens to the hepatocytes, the chief functional cells of the liver, which produce the protein Lgr5, under different liver conditions, normal, cancerous and injured. It was found that under normal conditions, this specific subset of cells were able to regenerate and continue its own lineage, but in injured and cancerous livers, these cells are susceptible to turning into cancer cells and cause the growth of tumours.

“This important discovery by our researchers could potentially lead to novel strategies for effective hepatocellular carcinoma diagnosis and treatment,” said Professor Patrick Casey, Senior Vice Dean for Research as Duke-NUS.

The researchers are now trying find out more about this pathogenesis process and what causes normal cells to turn into cancerous cells under these conditions. They hope that they are able to extend from their findings and sift out a new, more effective treatment for liver cancer.

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