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Effectiveness of HCC surveillance programs using multitarget blood test: A modeling study.

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  • 1Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Department of Radiology, Boston, Massachusetts, USA.

Hepatology Communications
|May 19, 2023
PubMed
Summary

A new multitarget HCC blood test (mt-HBT) shows promise for improving early liver cancer detection in cirrhosis patients. This blood test, especially with better adherence, significantly increases early-stage hepatocellular carcinoma (HCC) detection and life years gained compared to ultrasound surveillance.

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Area of Science:

  • Hepatology
  • Oncology
  • Biomarker Discovery

Background:

  • Ultrasound surveillance for hepatocellular carcinoma (HCC) in cirrhosis patients has limitations in early detection and adherence.
  • Blood-based biomarkers are emerging as potential alternatives for HCC surveillance.
  • This study evaluates a multitarget HCC blood test (mt-HBT) against ultrasound-based surveillance.

Purpose of the Study:

  • To compare the effectiveness of mt-HBT, with and without improved adherence, against ultrasound-based HCC surveillance.
  • To assess the impact of different surveillance strategies on early HCC detection and life years gained.

Main Methods:

  • A Markov-based mathematical model simulated a virtual trial in patients with compensated cirrhosis.
  • Compared biannual ultrasound, ultrasound plus AFP, and mt-HBT (with/without +10% adherence).
  • Utilized published data on liver disease progression, HCC growth, surveillance performance, and treatment efficacy.

Main Results:

  • mt-HBT detected 1680 more early HCCs than ultrasound alone and 350 more than ultrasound + AFP per 100,000 patients.
  • mt-HBT with improved adherence detected 2200 more early HCCs than ultrasound and 880 more than ultrasound + AFP.
  • Significant increases in life years gained were observed with mt-HBT, especially with improved adherence.

Conclusions:

  • Multitarget HCC blood test (mt-HBT) is a promising alternative to ultrasound-based surveillance.
  • Improved adherence with blood-based biomarkers can enhance HCC surveillance effectiveness.
  • mt-HBT offers a potential strategy to improve early detection and outcomes for cirrhosis patients at risk of HCC.