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Liver Cancer

Improving diagnostic techniques for the most difficult to detect cancers

Liver cancer is very challenging to diagnose, and confirmation of the disease often comes too late for treatment to be successful. Around 2,200 Canadians are diagnosed annually, and 1,100 people will die of liver cancer each year – more than two-thirds of them men.

Frustrated by these challenges, one TFRI-funded team is using innovate new imaging techniques to improve the outcomes of patients with hepatocellular carcinoma, the most common type of liver cancer. The study is based in Vancouver, B.C. in collaboration with the National Science Council (NSC) of Taiwan; liver cancer is a major cause of death amongst people of east and Southeast Asian descent, a demographic that is heavily represented in the Vancouver-area.

“Liver cancer is one of those diseases that is really hard to treat,” said Dr. François Bénard, a clinician-scientist based at the BC Cancer Agency. “Unfortunately, many patients have a poor outcome because it’s diagnosed late and it’s too advanced by the time lesions are detected by existing imaging methods.”

To counter this, the team is investigating several new promising radioactive sugars, including Fluoro-2-deoxy-D-galactose (FDGal) and Fluorocholine (FC), with the hope that they will be more effective in detecting liver cancer than current options.

The process is intricate: Small atoms that emit rays are attached to special sugar that is metabolized by the liver and incorporated by liver cancers. After being injected into the patient, the sugar accumulates in tumours, which then become visible on Positron Emitting Topography (PET) imaging scans.

“We believe that we’ll improve the way that liver cancers are detected, not only to find out whether people have cancer or not, but to see how extensive it is and whether it’s spread elsewhere,” explains Dr. Bénard.

The Canadian group will compare FDGal to another radioactive sugar currently being used in cancer imaging but that is known to be ineffective for detecting liver cancer (FDG), while the Taiwanese group will compare the two promising sugars, FDGal and FCH. Clinical trials are being held in both countries, with 50 patients in each group.

“We have two goals: one of them is when we see a lesion in a patient that’s at high-risk for liver cancer, to figure out whether this is cancer or not,” says Dr. Bénard. “The secondary aim is to evaluate whether those imaging methods can really document whether the cancer has spread elsewhere or is contained.

“We hope this multidisciplinary project will lead to concrete, practical results that will improve the care of cancer patients.”

Project Title: National Science Council (NSC) of Taiwan and TFRI Scientific Collaboration: Development of 2-[18F]fluoro-2-deoxy-D-galactose as a new molecular imaging probe for hepatocellular carcinoma diagnosis (2013-2016)

Investigators: François Benard, BC Cancer Agency

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