Issues and controversies of hepatocellular carcinoma-targeted therapy clinical trials in Asia: Experts'opinion

Pei Jer Chen, Junji Furuse, Kwang Hyub Han, Chiun Hsu, Ho Yeong Lim, Han Lim Moon, Shukui Qin, Sheng Long Ye, Ee Min Yeoh, Winnie Yeo

Research output: Contribution to journalReview articlepeer-review

37 Citations (Scopus)


Asia has a disproportionate share of the world's burden of hepatocellular carcinoma (HCC). However, the highly regarded clinical practice guidelines and recommendations for the design and conduct of clinical trials for HCC largely reflect Western practice. In order to design mutually beneficial international clinical trials of promising targeted therapies, it is imperative to understand how the aetiology, staging and treatment of HCC differ between Asian and Western countries. Our group, comprising experts in oncology and hepatology from countries that constitute the Eastern Asian region, convened to compare and contrast our current practices, evaluate potential compliance with the clinical trial recommendations, and offer suggestions for modifications that would enhance international collaboration. Here, we describe the results of our discussions, including recommendations for appropriate patient stratification based on potentially important differences in HCC aetiology, identification of practices that may confound interpretation of clinical trial outcomes (traditional Chinese medicine; antivirals that target hepatitis B virus; heterogeneous embolization procedures), suggestions for utilizing a common staging system in study protocols, recognition that sorafenib usage is limited by financial constraints and potentially increased toxicity in Asian patients, and expansion of patient populations that should be eligible for initial clinical trials with new agents.

Original languageEnglish
Pages (from-to)1427-1438
Number of pages12
JournalLiver International
Issue number10
Publication statusPublished - 2010 Nov

All Science Journal Classification (ASJC) codes

  • Hepatology


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