Amit Singal, M.D., M.S.
UT Southwestern will lead a multisite initiative funded by the National Cancer Institute (NCI) to identify biomarkers to improve risk assessment and early detection of hepatocellular cancer (HCC), the most common form of liver cancer, among patients with cirrhosis.
A new Clinical Validation Center, to be funded through a five-year grant from NCI’s Early Detection Research Network, will seek to validate novel blood and imaging biomarkers in clinical trials to identify more precisely which patients are most at risk for HCC and improve early detection.
“This project is about replacing our current one-size-fits-all strategy with precision screening techniques that provide accurate risk stratification of patients and early detection of HCC,” said Amit Singal, M.D., M.S., Professor of Internal Medicine in the Division of Digestive and Liver Diseases, Medical Director of the Liver Tumor Program, and Chief of Hepatology at UT Southwestern.
Each year, about 25,000 men and 11,000 women get liver cancer, and about 19,000 men and 9,000 women die from the disease, according to the Centers for Disease Control and Prevention.
Since patients with cirrhosis (impaired liver function due to scar tissue buildup) have a 1% to 3% annual risk of developing HCC, they are encouraged to be screened every six months. Cirrhosis patients who also have indeterminate liver nodules are at an increased annual risk of 6% to 10%.
Yet all patients with cirrhosis go through the same semiannual screening protocol: an abdominal ultrasound and a blood test for alpha-fetoprotein (AFP). If either is positive, further diagnostic imaging is done. But the current protocol misses over one-third of early-stage HCCs.
“What we need are better biomarkers that can help us predict who is at greatest risk for HCC and who doesn’t need to be screened as frequently,” said Dr. Singal, a Dedman Family Scholar in Clinical Care and member of the Harold C. Simmons Comprehensive Cancer Center.
To support the rapid verification of novel biomarkers, the NCI’s U01 grant will provide nearly $6 million over five years to researchers at UTSW, the University of Michigan, Baylor College of Medicine, and the University of Pennsylvania. The four sites will collect and catalog images and blood samples of patients as they are followed over time. Then, newly proposed biomarkers can be tested retrospectively against the pooled collection.
Dr. Singal holds the Willis C. Maddrey, M.D. Distinguished Chair in Liver Disease.