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Semin Liver Dis 2022; 42(04): 501-513
DOI: 10.1055/a-1942-6693
Review Article

Hepatocellular Carcinoma Chemoprevention with Generic Agents

Fahmida Rasha
1   Liver Tumor Translational Research Program, Simmons Comprehensive Cancer Center, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
,
Subhojit Paul
1   Liver Tumor Translational Research Program, Simmons Comprehensive Cancer Center, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
,
Tracey G. Simon
2   Liver Center, Division of Gastroenterology, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Yujin Hoshida
1   Liver Tumor Translational Research Program, Simmons Comprehensive Cancer Center, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
› Author Affiliations
Funding Funding received from Cancer Prevention and Research Institute of Texas (RR180016, RP200554); U.S. Department of Health and Human Services, National Institutes of Health, Center for Scientific Review (CA233794, CA127003, CA226052, CA255621, DK122104); European Commission (ERC-2014-AdG-671231, ERC-2020-ADG-101021417)
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Abstract

Liver cancer, mainly hepatocellular carcinoma (HCC), remains a major cause of cancer-related death worldwide. With the global epidemic of obesity, the major HCC etiologies have been dynamically shifting from viral to metabolic liver diseases. This change has made HCC prevention difficult with increasingly elusive at-risk populations as rational target for preventive interventions. Besides ongoing efforts to reduce obesity and metabolic disorders, chemoprevention in patients who already have metabolic liver diseases may have a significant impact on the poor HCC prognosis. Hepatitis B– and hepatitis C–related HCC incidences have been substantially reduced by the new antivirals, but HCC risk can persist over a decade even after successful viral treatment, highlighting the need for HCC-preventive measures also in these patients. Experimental and retrospective studies have suggested potential utility of generic agents such as lipophilic statins and aspirin for HCC chemoprevention given their well-characterized safety profile, although anticipated efficacy may be modest. In this review, we overview recent clinical and translational studies of generic agents in the context of HCC chemoprevention under the contemporary HCC etiologies. We also discuss newly emerging approaches to overcome the challenges in clinical testing of the agents to facilitate their clinical translation.

Keywords

generic agent - hepatocellular carcinoma - chemoprevention - biomarker - drug repurposing


Publication History

Accepted Manuscript online:
14 September 2022

Article published online:
14 October 2022

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