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Earlier detection of liver cancer

Background:

Cancer that begins in the liver (hepatocellular carcinoma) is one of the fastest rising and fourth commonest cause of deaths due to cancer worldwide. Liver cancer is usually associated with liver viral infections, alcohol and obesity, causing the immune system to attack the liver leading to scarring and liver nodules (liver cirrhosis). We know that changes throughout the cirrhotic liver tissue are the major risk factor for liver cancer, but we do not understand the nature of these changes, or why and when some people develop cancer and others do not. So far, little effort has been made to characterise these changes. Furthermore, the tests (ultrasound scan and a single blood test) that we currently use to diagnose liver cancer at an early stage, when the cancer can be treated, fail in 6 out of 10 people. As a result, the vast majority of people are first diagnosed when their cancer is too advanced to be treated.

Our research:

We aim to:

  1. Better understand the changes within the liver that lead to cancer
  2. Detect liver cancer at the earliest stages when curative therapies may be applied.

We have gathered a team of internationally renowned scientists with different but complementary skills to maximise the chances that our project will be successful. We are taking samples of the liver from people with and without liver cancer, in a safe procedure that uses very fine needles and compare how cells in the liver are functioning in great detail. New imaging technologies (magnetic resonance imaging) is being used to assess the whole liver to identify those at most risk of cancer and to detect small tumours early. We are also measuring proteins that are already known to be associated with liver cancer and other biomarkers in the blood, using the most promising technologies available. Finally, we are working with Dr Chunxiao Song’s group to develop an exciting new blood test (TAPS), that can measure changes in DNA (the building blocks of cells) that is released from the liver cancer, or the liver at risk of cancer, into the blood.

Our aspirations:

We believe that our approach will lead to a much better understanding of the biological reasons for the development of liver cancer. We hope also that in using the best combination of the most promising tests, we will be able to identify cancer at the very earliest stages so that people can be cured.

Developing hepatitis vaccines

My group has led early human experimental medicine studies with the aims of developing a vaccine to prevent hepatitis C virus (HCV) infection. Most recently we have been developing vaccines that are specifically designed to target all the different types of HCV (variants), each of which is found in different parts of the world.  The group also has a programme that is developing vaccines to cure people that are infected with hepatitis B virus (HBV). We are working with Vaccitech (a company that spun out of Oxford) to assess new HBV vaccines, given with drugs that are usually used for cancer therapy (called check point inhibitors), to “turn on” an immune response against the virus.