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Individualized hepatocellular carcinoma risk: the challenges for designing successful chemoprevention strategies.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2013 Mar 07; Vol. 19 (9), pp. 1359-71. - Publication Year :
- 2013
-
Abstract
- Hepatocellular carcinoma (HCC) develops in the context of environmental risk factors like chronic viral hepatitis, diabetes and alcohol exposure, often associated to an increased risk of cirrhosis. Antiviral treatments that are effective to counteract hepatitis B and C may also attenuate the risk of tumor development. However, since hepatitis B-related carcinogenesis is promoted independently of the onset of cirrhosis, such antiviral treatments as nucleo(t)side analogs can promote regression of cirrhosis, prevent clinical decompensation and variceal bleeding but not HCC. This means that in successfully treated patients with cirrhosis, HCC is often the consequence of their extended survival. In hepatitis C patients, a sustained virological response to interferon-based therapies can reduce the rate of HCC development, even in patients with cirrhosis who experience histological regression of their liver disease. Future therapies aimed at this endpoint in at risk populations should take into consideration pretreatment patient stratification for host, viral and environmental risk factors. In this context the recent discovery of single nucleotide polymorphisms involved in the immune system function and tumorigenesis, might permit enrollment of populations of patients enriched with HCC risk factors for targeted chemopreventive therapies. This could finally pave the way to personalized algorithms, as already seen in the diagnosis and treatment schemes for chemoprevention.
- Subjects :
- Alcohol Abstinence
Alcohol Drinking adverse effects
Antiviral Agents therapeutic use
Carcinoma, Hepatocellular etiology
Carcinoma, Hepatocellular genetics
Genetic Predisposition to Disease
Hepatitis B complications
Hepatitis B drug therapy
Hepatitis C complications
Hepatitis C drug therapy
Humans
Liver Neoplasms etiology
Liver Neoplasms genetics
Metabolic Syndrome complications
Metabolic Syndrome therapy
Polymorphism, Single Nucleotide
Risk Assessment
Risk Factors
Risk Reduction Behavior
Carcinoma, Hepatocellular prevention & control
Chemoprevention methods
Liver Neoplasms prevention & control
Precision Medicine
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 19
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 23538741
- Full Text :
- https://doi.org/10.3748/wjg.v19.i9.1359