The M2BE (Multiscale Mechanical and Biological Engineering) research group is participating in a new project focused on liver cancer. The Engineering Research Institute of Aragon (I3A) of the University of Zaragoza is one of the 10 research centres where laboratory studies will be carried out to identify markers to predict the patient's response before starting treatment and personalise the therapy.
The project, ‘ASPIRE-AECC: Improving the survival of liver cancer patients by combining immunotherapy and surgery’, was launched on 28 February in Madrid at a meeting attended by 50 doctors and researchers. The project is supported with eight million euros by the Spanish Association Against Cancer, within the framework of the Association's ‘AECC 70% Survival Challenge Aid’, which seeks to contribute to achieving its goal of exceeding 70% cancer survival in 2030.
On behalf of the M2BE group, José Manuel García Aznar and Elena García Gareta attended the kick-off meeting, highlighting the fact that this new research project is ‘very patient-centred’ and involves a large number of clinical and basic research groups.
The coordinators of ASPIRE-AECC are Josep Maria Llovet, head of the IDIBAPS group in translational research in liver oncology, ICREA professor and Professor of Medicine at the UB and at the Icahn School of Medicine at Mount Sinai; and Xosé R Bustelo, Research Professor at the Spanish National Research Council (CSIC) and Director of the Salamanca Cancer Research Centre (CSIC-University of Salamanca and the Cancer Research Foundation of the University of Salamanca).
The six-year project aims to conduct a randomised clinical trial to increase survival in patients with early-stage hepatocellular carcinoma at high risk of developing a new tumour after surgical removal. To do this, immunotherapy (atezolizumab plus bevacizumab) will be administered before and after tumour surgery to promote an increased anti-tumour immune response.
Markers will also be defined to provide the possibility of predicting response to treatment in order to move towards more personalised therapy, as well as identifying alternative therapies for patients who show resistance to immunotherapy treatment.
The clinical trial will be carried out in 15 hospitals, while the laboratory studies will be conducted in 10 basic-translational research centres. A total of 40 doctors and researchers from 25 centres in 15 provinces will participate in the project: A Coruña, Badajoz, Barcelona, Bizkaia, Cantabria, Cordoba, Girona, Lleida, Malaga, Madrid, Navarra, Salamanca, Seville, Valencia and Zaragoza.
As explained by the Spanish Association Against Cancer Scientific Foundation, hepatocellular carcinoma is the most common liver cancer, a highly aggressive tumour, associated with survival rates of less than 30%, which is detected in some 6,500 people per year in Spain. Surgical removal or liver transplantation are the main current treatments, although they are only applicable to 25% of patients. Another problem affecting survival is that the tumour usually recurs in 30-50% of cases 3 years after surgery.
To address this clinical challenge, the ASPIRE-AECC project raises three key issues:
- Developing therapies that enhance clinical response and eliminate tumour recurrence
- Establish markers to identify patients who will respond favourably to the treatments applied.
- Search for therapeutic alternatives for patients who show resistance to the therapies developed against this tumour.
The 15-hospital clinical trial will investigate whether the combined administration of two immunotherapies both before and after tumour removal increases disease-free survival in patients with hepatocellular carcinoma, as is the case in lung cancer and melanoma.
In addition, with the samples obtained from the patients in this clinical trial, scientific work in 10 national research centres will attempt to identify markers to predict the patient's response before starting treatment and thus personalise the therapy. Finally, they will determine the possible mechanisms of tumour resistance to these therapies and how to combat them pharmacologically.
‘We are confident that the multifaceted nature of this consortium, together with the demonstrated experience of the different groups in conducting clinical trials and disruptive research, makes our overall goal - the equitable improvement of overall survival in patients with hepatocellular carcinoma - feasible,’ say the project coordinators.
