Platelets and Hepatocellular Cancer: Bridging the Bench to the Clinics

Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells' extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet-tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC

Overview of prognostic systems for hepatocellular carcinoma and ITA.LI.CA external validation of MESH and CNLC classifications

Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described

Platelets and hepatocellular cancer: Bridging the bench to the clinics

Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells\u2019 extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet\u2013tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC

Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows

With the introduction of direct-acting antiviral agents (DAA), the rate of sustained virological response (SVR) in the treatment of hepatitis C virus (HCV) has radically improved to over 95%. Robust scientific evidence supports a beneficial role of SVR after interferon therapy in the progression of cirrhosis, resulting in a decreased incidence of hepatocellular carcinoma (HCC). However, a debate on the impact of DAAs on the development of HCC is ongoing. This review aimed to analyse the scientific literature regarding the risk of HCC in terms of its recurrence and occurrence after the use of DAAs to eradicate HCV infection. Among 11 studies examining HCC occurrence, the de novo incidence rate ranged from 0 to 7.4% (maximum follow-up: 18 mo). Among 18 studies regarding HCC recurrence, the rate ranged from 0 to 54.4% (maximum "not well-defined" followup: 32 mo). This review highlights the major difficulties in interpreting data and reconciling the results of the included studies. These difficulties include heterogeneous cohorts, potential misclassifications of HCC prior to DAA therapy, the absence of an adequate control group, short follow-up times and different kinds of follow-up. Moreover, no clinical feature-based scoring system accounts for the molecular characteristics and pathobiology of the tumours. Nonetheless, this review does not suggest that there is a higher rate of de novo HCC occurrence or recurrence after DAA therapy in patients with previous HCV infection. \ua9 2018 The Author(s). Published by Baishideng Publishing Group Inc. All rights reserved

Platelets and hepatocellular cancer: Bridging the bench to the clinics

Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells' extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet-tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC

Potential impacts of increasing average yields and reducing maize yield variability in Africa

This study evaluates the potential impacts of investing in Drought Tolerant Maize (DTM) in 13 countries of East, South and West Africa. The analysis utilizes geo-referenced production data at the regional and household levels and employs a model that estimates both the conventional mean yield gains and the additional benefits from yield stability gains of DTM varieties as well as impacts on poverty. The results indicate that by 2016, adoption of DTM can generate between US$362 million and US$ 590 million in cumulative benefits to both producers and consumers. Yield variance reductions stand to generate considerable benefits, especially in high drought risk areas. These benefits translate into poverty reductions in the range of 0.01–4.29% by 2016. Significant benefits are also found among different types of households living in drought risk areas of Kenya, Ethiopia and Nigeria

Potential impact of investments in drought tolerant maize in Africa

The study evaluates the potential impacts of the Drought Tolerant Maize for Africa (DTMA) project run by CIMMYT and the International Institute for Tropical Agriculture (IITA) in 13 countries of eastern, southern and West Africa: Angola, Benin, Ethiopia, Kenya, Malawi, Mali, Mozambique, Nigeria, Tanzania, Uganda, Zambia, and Zimbabwe and Ghana. It describes cumulative economic and poverty-reduction benefits to farmers and consumers in those countries over 2007-16, from higher yields and from diminished season-to-season yield fluctuations, through the adoption by farmers of improved, drought tolerant maize varieties. At the most likely rates of adoption, based on several recent studies and expert advice, drought tolerant maize can generate US$0.53 billion from increased maize grain harvests and reduced risk over the study period, assuming conservative yield improvements—that is, a yield advantage over normal, improved maize of 3-20nearly US$ 0.88 billion in project countries. Optimistic yields plus full replacement of current improved varieties with drought tolerant ones could help more than 4 million people to escape poverty and many millions more to improve their livelihoods. The most striking economic and poverty benefits will accrue in Nigeria, Kenya, and Malawi, based on the amounts of maize sown in those countries, the importance of maize in inhabitants’ diets and livelihoods, and their historical levels of adoption of improved maize. In comparison, the benefits will be more modest in Angola and Mozambique and moderate in Uganda and Mali. However, even if most DTMA project resources were allocated to the countries where the benefits are highest, the other countries would still benefit from the research spillovers that could be facilitated by crossborder seed market exchanges. Crucial components in this multi-disciplinary study included geographic information system data, data on the probability of failed crop seasons (PFS), yield data from breeders, projected maize adoption rates mainly from seed experts, and poverty data from socioeconomists. The drought tolerant varieties considered are the product of conventional breeding—that is, they are not transgenic. Follow-up research will address potential benefits from such factors as area expansion effects, increased cropping diversity (households can meet their maize requirements from a smaller portion of their land, freeing up space to sow other crops), and increased investment in fertilizer and other improvements, owing to reduced risk. Moreover, if as expected farmers who adopt drought tolerant maize continue to grow it beyond 2016, the returns on investments to this work will become even more significant