Assessing Liver Function in Patients with HCC

Rachna Shroff, MD, MS, FASCO, discusses hepatocellular carcinoma, noting its rising global incidence and identifying underlying liver cirrhosis as a key risk factor influenced by conditions like viral hepatitis and fatty liver disease; diagnosis often involves radiographic imaging and triple-phase CT and MRI scans, while treatment necessitates a multidisciplinary approach involving hepatologists, surgeons, and other specialists.

Drs Vogel and Singal discuss the critical importance of assessing liver function in hepatocellular carcinoma patients, as it impacts prognosis and treatment strategies; they mention the evolution from Child-Pugh scoring to the ALBI score, which uses albumin and bilirubin levels, for a more objective evaluation of liver health.

The ALBI score, originally developed to stratify cirrhotic patients undergoing resection, has evolved into a vital tool for assessing prognosis and treatment efficacy in various stages of hepatocellular carcinoma and is now being explored for its utility in other liver-related diseases.

Arndt Vogel, MD, explains that the Child-Pugh score, although simpler to calculate than the ALBI score, sometimes lacks granularity in assessing liver function in hepatocellular carcinoma patients; however, both scoring systems are considered valuable tools in clinical settings and trials for evaluating liver function's prognostic impact on treatment outcomes.

Rachna Shroff, MD, MS, FASCO, and Amit Singal, MD, discuss the use of various liver function assessment scores—Child-Pugh, ALBI, and MELD—in the care of patients with hepatocellular carcinoma, emphasizing their pros, cons, and roles in treatment decision-making.

Arndt Vogel, MD, discusses the post-hoc analyses of two key clinical trials focusing on the impact of liver function, measured by ALBI and Child-Pugh scores, on outcomes in hepatocellular carcinoma treatments.

Amit Singal, MD, reviews analyses of the HIMALAYA and KEYNOTE-240 trials, focusing on the impact of liver function via ALBI grades on treatment outcomes and safety in patients with hepatocellular carcinoma.

Rachna Shroff, MD, MS, FASCO, shares data from the CARES-310 study showing improved progression-free and overall survival in patients with hepatocellular carcinoma treated with camrelizumab and rivoceranib compared to sorafenib, regardless of liver function.

Experts emphasize the importance of using multiple liver function assessments for more comprehensive patient evaluation in hepatocellular carcinoma treatment.