AHCC Trials Group: Revolutionising Liver Cancer Care in the Asia-Pacific
Diane Galistan, 2 August 2024
Tackling the Hepatocellular Carcinoma Epidemic in Asia-Pacific
Hepatocellular carcinoma (HCC) is a pressing public health concern in the Asia-Pacific region, where over 80% of the world's HCC cases are found. This staggering statistic is driven by high rates of chronic viral hepatitis B and the increasing prevalence of metabolic risk factors, making the APAC region a global hotspot for HCC.
Addressing Unmet Clinical Needs
HCC is one of few cancers today where incidence approximates mortality. Early diagnosis remains a challenge, and only around 20% of HCCs are subject to change to potentially curative ablative therapies at the point of diagnosis. Until recently, the prognosis for HCC patients in Asia-Pacific was often guarded, with limited effective therapies beyond early-stage surgical interventions.
These stats highlight the importance of addressing these unmet public health needs:
● Early Diagnosis: The current screening approach for individuals at high risk of hepatocellular carcinoma (HCC) in the Asia-Pacific region involves a combination of 6-monthly serum alpha-fetoprotein (AFP) testing and ultrasound (U/S) imaging.
Specifically, the sensitivity of U/S alone for early-stage HCC is only 47%, meaning that more than half of these early, potentially curable tumours are being missed. Even when combining AFP testing with U/S, the sensitivity only increases to 63%, still leaving a substantial proportion of patients with early HCC undiagnosed.
● Predictive Biomarkers: Despite the rapid development of novel systemic therapies for advanced HCC, the clinical benefit of these treatments remains highly variable. The lack of validated predictive biomarkers means clinicians cannot reliably identify which patients are most likely to respond to a given therapy, leading to suboptimal treatment outcomes. Addressing this unmet need for predictive biomarkers could enable a more personalized approach to HCC management and improve patient outcomes.
Recognising the urgent unmet clinical needs, a group of visionary clinicians from major medical centres across the Asia-Pacific region came together in 1997 to form the Asia-Pacific Hepatocellular Carcinoma (AHCC) Trials Group to address this challenge requiring the development and validation of more sensitive and specific biomarkers and imaging modalities that can reliably identify HCC at its earliest stages, when the disease is most treatable.
Harnessing the Power of Collaboration
Led by Protocol Chair Professor Pierce Chow, the Asia-Pacific Hepatocellular Carcinoma (AHCC) Trials Group was set up in 1997, where a group of clinicians from major medical centres in the Asia-Pacific region launched a single-centre prospective HCC clinical trial initiated by the Singapore General Hospital. This effort soon expanded into a multi-centre trial across the Asia-Pacific region. Professor Chow’s research interests are in hepatocellular carcinoma and steatohepatitis.
Recognising the lack of effective therapies and the aggressive nature of HCC, these clinicians saw the urgent need for a coordinated, regional approach to develop better treatment options for the large patient population in the Asia-Pacific. The AHCC Trials Group was founded on the principle that by pooling their resources and expertise, clinicians in the region could accelerate the development of more effective HCC treatments through large-scale, multinational clinical trials.
Over the past 25 years, the AHCC network has grown to include 62 participating centres across 17 countries including Singapore, China, Indonesia, Japan, and more, enabling the enrollment of more than 4,000 patients in 8 prospective, multicenter studies.
This collaborative approach has been instrumental in driving progress against HCC, a disease that disproportionately affects the Asia-Pacific population.
Pioneering Innovative HCC Trials to Improve Patient Outcomes
The AHCC Trials Group has been at the forefront of clinical research and innovation, and their studies have explored a diverse range of interventions, from novel systemic therapies to innovative local-regional treatments, all to improve outcomes for HCC patients.
Some of the group's key achievements include:
● Completing eight prospective, multicenter HCC trials involving over 4,000 patients
● Establishing strong alliances with industry and academic partners to accelerate innovation
● Developing training and educational programs to build regional capacity in HCC management.
Driving Towards a Brighter Future
AHCC is committed to improving the lives of individuals at risk of HCC. Some of the ongoing and upcoming clinical trials include:
● NCT04965259 Early detection of HCC: miRNA, microbiome and imaging biomarkers in the evolution of chronic liver disease in a high-risk prospective cohort (ELEGANCE)
● NCT05148572 Prospective Cohort Study of Changes in Circulatory MicroRNA after Surgical Resection of HCC (PROSECT)
● Precision Medicine in Liver Cancer across an Asia-Pacific Network 2.0 (PLANet 2.0)
● NCT05377034 A multinational, double-blind, placebo-controlled, parallel randomised arms, phase II trial to compare the safety and efficacy of SIRT-Y90 followed by atezolizumab plus bevacizumab versus SIRT-Y90 followed by placebo in patients with locally advanced HCC (STRATUM)
By leveraging the vast patient population and diverse expertise within the Asia-Pacific ecosystem, the group is poised to continue pioneering groundbreaking HCC trials that will transform the lives of patients across the region.
Through their tireless efforts, the AHCC Trials Group is not only advancing the clinical management of HCC but also fostering a spirit of regional cooperation that will be crucial in tackling this devastating disease. As we look ahead, the group's work is a shining example of how collaborative research can drive meaningful progress in global health.
AHCC Members
No. | Country | Institution | Name of PI |
1 | Australia | Austin Health | Prof Jonathan Cebon (AHCC01) |
2 | Australia | Royal Adelaide Hospital | Prof Edmund Tse (AHCC08) |
3 | Australia | Royal Prince Alfred Hospital | A/Prof Simone Strasser (AHCC08) |
4 | Brunei | The Brunei Cancer Centre | A/Prof Kenneth Kok Yuh Yen (AHCC06) |
5 | China | Guangxi Medical University Cancer Center | Prof Li Lequn (AHCC08) |
6 | China | Second Affiliated Hospital Zhejiang University School of Medicine | Prof Jiangtao Li (AHCC08) |
7 | China | Zhongshan Hospital, Fudan University | Prof Fan Jia (AHCC08) |
8 | China | Beijing Cancer Hospital | Prof Zhu Xu (AHCC08) |
9 | China | Harbin Medical University Cancer Hospital | Prof Yuxian Bai (AHCC08) |
10 | China | Nanjing Bayi Hospital | Prof Qin Shu-Kui (AHCC08) |
11 | Hong Kong | Queen Mary Hospital | Prof Thomas Yau (AHCC08) |
12 | Hong Kong | Prince of Wales Hospital, Chinese University of Hong Kong (now University of Liverpool) | Prof Philip Johnson (AHCC01) |
13 | Indonesia | Sanglah General Hospital | Prof Tjakra Wibawa Manuaba (AHCC01 and AHCC06) |
14 | Indonesia | University of Indonesia | Prof L.A. Lesmana (AHCC06) |
| Indonesia | MRCCC Siloam Semanggi Hospital | Cosmas Rinaldi A. Lesmana |
15 | Japan | Kindai University Hospital | Prof Masatoshi Kudo (AHCC08) |
16 | Japan | Kyorin University School of Medicine (now Kanagawa Cancer Center) | Prof Junji Furuse (AHCC08) |
17 | Japan | National Cancer Centre | Dr Kazuaki Shimada (AHCC08) |
18 | Japan | University of Tokyo | Prof Kiyoshi Hasegawa (AHCC08) |
19 | Japan | National Center of Global Health and Medicine | Dr Nobuyuki Takemura (AHCC08) |
20 | Malaysia | Penang Adventist Hospital | Dr Aloysius Raj (AHCC06) |
21 | Malaysia | Prince Court Medical Centre (previously Selayang Hospital) | Datuk Dr Harjit Singh (AHCC05) |
22 | Malaysia | Sarawak General Hospital | Dr Nik Azim Bin Nik Abdullah (AHCC06) |
23 | Malaysia | University Malaya Medical Center | A/Prof Koh Peng Soon (AHCC06 and AHCC07) |
24 | Malaysia | Hospital Universiti Kebangsaan | Dr Haron Ahmad (AHCC01) |
25 | Mongolia | National Cancer Centre | Dr Ariunaa Khasbazar (AHCC06) |
26 | Myanmar | Yangon GI & Liver Centre | Prof Khin Maung Win (AHCC01, AHCC02, AHCC05 and AHCC06) |
27 | New Zealand | Auckland City Hospital | Dr Adam Bartlett (AHCC06 and AHCC08) |
28 | New Zealand | Cancer Trials New Zealand | Prof Michael Findlay (AHCC01 and AHCC02) |
29 | Philippines | Davao Doctors’ Hospital | Dr Rolley Rey Lobo (AHCC02 and AHCC06) |
30 | Philippines | Makati Medical Center | Dr Catherine Teh (AHCC06) |
31 | Philippines | St. Luke’s Medical Center | Dr Ian Homer Y. Cua (AHCC06) |
32 | Philippines | The Medical City | Dr Janus Ong (AHCC06), Dr Vanessa De Villa (AHCC07) |
33 | Singapore | Changi General Hospital | Dr Eugene Wong Yu Jun (AHCC10), Dr Chiow Kah Heng Adrian (AHCC11 and AHCC12) |
34 | Singapore | Khoo Teck Puat Hospital | Prof Kenneth Mak (AHCC06) |
35 | Singapore | National Cancer Centre | Prof Soo Khee Chee (AHCC01 and AHCC02), Prof Pierce Chow (AHCC04, AHCC07, AHCC08, AHCC10, AHCC11, AHCC12), Prof Toh Han Chong (AHCC09 and AHCC13), Prof Thng Choon Hua, Dr David Tai (AHCC05, AHCC06) |
36 | Singapore | National University Hospital | A/Prof Glenn Bonney (AHCC07, AHCC11 and AHCC12), Prof Dan Yock Young (AHCC06, AHCC08), Dr Chee Cheang Ean (AHCC09 and AHCC13), Dr Lee Guan Huei (AHCC10) |
37 | Singapore | Singapore General Hospital | Prof Pierce Chow (AHCC02), Dr Richard Lo Hoau Gong (AHCC05), Prof Alexander Chung (AHCC03 and AHCC05), A/Prof David Ng Chee Eng, Dr Cheow Peng Chung (AHCC06), Prof Brian Goh (AHCC07, AHCC08, AHCC11 and AHCC12), A/Prof Jason Chang Eu Pik (AHCC10) |
38 | Singapore | SingHealth Polyclinic - Bedok | Dr Chong Oi Fong (AHCC10) |
39 | Singapore | SingHealth Polyclinic - Bukit Merah | Dr Wee Yi-Mei Sabrina (AHCC10) |
40 | Singapore | SingHealth Polyclinic - Marine Parade | Dr Tan Kee Tung (AHCC10) |
41 | Singapore | SingHealth Polyclinic - Outram | Dr Ong Kok Kiong (AHCC10) |
42 | Singapore | SingHealth Polyclinic - Pasir Ris | Clin A/Prof Tan Ngiap Chuan (AHCC10) |
43 | Singapore | SingHealth Polyclinic - Punggol | Dr Yeap Xin Yi (AHCC10) |
44 | Singapore | SingHealth Polyclinic - Sengkang | Dr Choo Wei Song Jeremy (AHCC10) |
45 | Singapore | SingHealth Polyclinic - Tampines | Dr Sulaiha Binte Ithnin (AHCC10) |
46 | Singapore | Sengkang General Hospital | Dr Marianne Anastasia De Roza (AHCC10), Dr Kam Juinn Huar (AHCC11 and AHCC12) |
47 | Singapore | Tan Tock Seng Hospital | Dr S. C. Chia (AHCC01), Dr Chew Soo Ping (AHCC03), Adj A/Prof Dr Yang Wei Lyn (AHCC10), Dr Vishalkumar G. Shelat (AHCC11), Dr Jens Samol (AHCC12) |
48 | South Korea | Asan Medical Centre | Prof Hyun-Ki Yoon (AHCC06 and AHCC08) |
49 | South Korea | Korea University Anam Hospital | Prof Kim Yun Hwan (AHCC06 and AHCC08) |
50 | South Korea | Samsung Medical Centre | Prof Joon-Hyeok Lee (AHCC08) |
51 | South Korea | Seoul National University Hospital | Prof Ho-Seong Han (AHCC05, AHCC06 and AHCC08) |
52 | South Korea | St. Vincents Hospital | Prof Si-Hyun Bae (AHCC01), Prof Yang Jin-Mo (AHCC02 and AHCC08) |
53 | South Korea | St. Mary’s Hospital | Prof Si-Hyun Bae (AHCC06), Dr Choi Jong-Young (AHCC08) |
54 | South Korea | Severance Hospital, Yonsei University College of Medicine | Prof Jong-Yun Won (AHCC06), Dr Do-Young Kim (AHCC08) |
55 | South Korea | Ajou University Hospital | Prof Hee-Jung Wang (AHCC08) |
56 | Taiwan | Chang Gung Memorial Hospital - Kaoshiung | Dr Tsung-Hui Hu (AHCC08) |
57 | Taiwan | Chang Gung Memorial Hospital - Linkuo | Dr Chien-Fu Hung (AHCC06) |
58 | Taiwan | China Medical University Hospital | Dr Peng Cheng-Yuan (AHCC06 and AHCC08) |
59 | Taiwan | National Cheng Kung University Hospital | Dr Pin-Nan Cheng (AHCC08) |
60 | Taiwan | National Taiwan University Hospital | Dr Po-Chin Liang (AHCC06), Dr Chien-Hung Chen (AHCC08) |
61 | Taiwan | Taipei Veterans General Hospital | Dr Rheun-Chuan Lee (AHCC06), Dr Yee Chao (AHCC08) |
62 | Thailand | Chulabhorn Hospital | Dr Chanisa Chotipanich (AHCC06) |
63 | Thailand | National Cancer Institute | Dr Thiravud Khuhaprema (AHCC01), Dr Rawisak Chanwat (AHCC07 and AHCC08) |
64 | Thailand | Siriraj Hospital, Mahidol University | Dr Supot Ninanong (AHCC08) |
65 | Vietnam | Choray Hospital | Dr Hoang Hoa Hai (AHCC02) |
66 | Vietnam | National Cancer Institute K Hospital | Dr Nguyen Ba Duc (AHCC02) |
67 | USA | Duke University School of Medicine | Dr Sabino Zani Jr (AHCC07) |