What’s New in Research and Treatment for Pediatric Liver Tumors?

Recent headways in pediatric liver tumor treatment include more targeted therapies that aim to hone in on the cancer and destroy it — while reducing the toxic effects of treatment on the body, when possible.

Liver tumors arise in the liver, the organ in the upper-right corner of the belly. There are two main types of liver tumors in pediatric patients, which are both very rare: hepatoblastoma and hepatocellular carcinoma. The former typically affects children aged three or younger, whereas the latter typically affects older children, adolescents, and adults.

Historically, clinicians have used two main mechanisms of treating liver tumors: chemotherapy and surgery. Surgery, however, remains the mainstay of liver tumor treatment and needs to be performed concurrently with chemotherapy. In cases where the tumor cannot be treated through surgery alone, liver transplants can be an option.

In the last few years, clinicians have been able to take treatment a step further through interventional radiology. This method allows direct delivery of chemotherapy or radioactive compounds through blood vessels, sparing the rest of the body from the toxic effects of chemotherapy and delivery treatment straight to the tumor, Allison F. O’Neill, MD, Director of the Pediatric Liver Tumor Program at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, said in a recent Facebook Live Q&A.

Clinicians are also able to treat some pediatric patients with “low-risk” hepatoblastoma – traditionally defined as patients who can have their cancer treated with surgery right when they are diagnosed – with lower doses of chemotherapy than ever before, while still achieving excellent outcomes, according to O’Neill.

Similarly, hepatoblastoma patients with “high-risk” disease – meaning, cancer that has spread to other parts of the body – have been able to be treated with chemotherapy drugs and other therapeutic regimens that work “so much better than before,” O’Neill said. This patient population once had a 50 percent survival rate, and now has a survival rate of more than 80 percent, O’Neill added.

At Dana-Farber/Boston Children’s, some hepatocellular carcinoma patients have been treated with immunotherapy, a type of treatment that uses the body’s immune system to fight cancer. Some have responded well to the therapy, and it should be studied further as an option for these patients, O’Neill said.

Learn more about symptoms of liver tumors, risk factors, side effects of treatment, and more about pediatric liver tumors:

Learn more about treatment for pediatric liver tumors from the Pediatric Liver Tumor Program at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.