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Princeton Workshop 2022

April 27-28, Timothy M. Block Research Campus, Doylestown, Pa.

Hepatitis B-Associated Liver Cancer: Opportunities to Address Gaps in Early Detection and Improve Outcomes

The Hepatitis B Foundation’s biennial Princeton Workshop this year focused on improving early detection of hepatocellular carcinoma (HCC), or primary liver cancer, the world’s third-leading cause of cancer deaths. Held April 27-28, 2022, at the Foundation’s Headquarters in Doylestown, Pa., the workshop was led by Dr. Brian J. McMahon, Dr. Chari A. Cohen, Dr. Timothy M. Block and members of the Foundation’s Scientific and Medical and Advisory Board.

Since our 2015 Princeton Workshop (which also focused on liver cancer), death rates from liver cancer have continued to rise despite the availability of a range of treatments. Outcomes are strongly associated with how advanced the cancer is when it is diagnosed, and most liver cancer is diagnosed at later stages. Current U.S. guidelines recommend liver cancer screening for people at risk every six months, to diagnose liver cancer at earlier states when it there is the greatest chance of cure. However, few people at risk access/undergo appropriate liver cancer surveillance.

The 2022 workshop participants discussed the most pressing challenges and barriers to the early detection of liver cancer, as well as tools and technologies that could improve early detection. Workshop participants reviewed technical, patient-level, provider-level and systemic challenges and missed opportunities to detect early stage liver cancer; algorithms for liver cancer risk stratification to help providers and patients more accurately assess their liver cancer risk; and surveillance tools such as new biomarkers and advanced imaging incorporating Artificial Intelligence (AI).

The workgroup identified that little meaningful progress has been made towards improving liver cancer surveillance or liver cancer survival in the past decade. Participants stated that action to reduce liver cancer mortality is urgently needed, with considerable concern that many of the challenges faced today are the same as those faced a decade ago. Participants stressed that increasing liver cancer surveillance is a priority, and that simultaneously, we must support research that develops and validates better screening tests and strategies. Dr. Brian McMahon will be leading the development of a manuscript of the workshop proceedings for peer-review.

Key Takeaways, Princeton Workshop 2022

  • Little progress has been made in the past decade towards improving liver cancer mortality rates.
  • There is an urgent need to improve and systematize liver cancer surveillance and early detection among those at high-risk.
  • We need to act swiftly to prioritize early detection to save lives. We cannot wait while incidence and mortality rates continue to rise each year.
  • Stakeholders need to work together to generate a national sense of urgency that will lead to change in policy and practice to improve liver cancer surveillance.
  • We should increase utilization of current screening tools while simultaneously developing better tests. Future research should focus on identification and validation of new biomarkers, and development of biorepositories to facilitate such research.
  • We must raise provider and patient awareness about the risk of cancer, the need for surveillance and early detection, and the availability of effective, curative treatments.
  • Patients and providers would benefit from development of a user-friendly liver cancer risk calculator.
  • We should design and investigate approaches to motivate providers and patients and decrease barriers to liver cancer surveillance.

2022 Princeton Workshop Participants

Princeton Workshop 2022

Front Row (L-R): Ying-Hsiu Su, Anna Suk-Fong Lok, Su Wang, Chari Cohen, Timothy Block, Dhruv Roy, JoAnn Rinaudo, Yasmin Ibrahim, Jake Liang, Elle Grevstad, Doan Dao, Catherine Freeland, Dianna Miller, Brian McMahon

Back Row (L-R): Aejaz Sayeed, George Ioannou, Ray Kim, Lewis Roberts, Theodore Welling, Amit Singal, Kenneth Rothstein, Anand Mehta, Thomas Karasic, Jorge Marrero, George Rogge, Hashem El-Serag, Beatrice Zovich, Robert Gish

Not Pictured: Robert Brown, William Grady, Josep Llovet, Edith Mitchell, Norah Terrault