Hepatocarcinoma in Sicily

Hepatocarcinoma in Sicily

It has been estimated that, in SIcily, hepatocarcinoma was the third cause of death among neoplastic diseases with the obvious consideration that the oncological network, cancer registries and Scientific Societies must continue the work of collaboration and implementation of their activities also because Sicily is still exposed to the risk of hepatocarcinoma on post-infectious cirrhosis but nowadays, it must pay particular attention to a population with an ever-increasing tendency to overweight and obesity.

These conditions often cause the so-called "metabolic syndrome" which, in the liver, is manifested by steatosis that can evolve into steatohepatitis, cirrhosis, HCC. A positive fact is the adhesion of the Reference Centers of the Island to a national network project called "United and Neighbors", sponsored by a well-known pharmaceutical multinational and patient association. In addition, the Regional Department of Health is currently developing the diagnostic-therapeutic assistance path (PDTA) for hepatocarcinoma that will guarantee the assistance of these patients only in highly specialized centers in Sicily. Finally, it is also worth considering the current possibility of a "tailored" antiblastic therapy for the acquisition of some new drugs and monoclonal antibodies.

The period of great planning and strategic decisions aimed at combating hepatocarcinoma presented itself with the opportunity to develop an idea of experimental research with considerable possibilities of clinical application. In fact, within the PON Research and Competitiveness 2007-13 the Universities of Palermo and Catania and the CNR presented several projects on the development of micro and nano technologies and advanced systems for human health (HIPPOCRATES – DRUG DELIVERY).

The project presented by our group hypothesized the possibility of using the only drug available at that time, against hepatocarcinoma (Sorafenib) not orally due to various side effects, but rather topically intratumorally.This technique had already been used for some time and consists in injecting into the arterial circulation of the tumor, by means of a super selective arteriography by trans femoris a scabolizing agent and a chemotherapeutic agent (Antiblastine). The indisputable superiority of Sorafenib over Antiblastine over hepatocarcinoma cells could not, however, be exploited for chemoembolization because Sorafenib is not injectable. The idea materialized in the production of micro and nano polymeric particles that conveyed microparticles of the drug inside the tumor with excellent results in terms of reduction of the tumor mass or its disappearance in vivo and in vitro in laboratory tests. Scientific publications and a patent testify to these results.

The POR-FERS 2014-20 "Liver smart drug" has signed a further opportunity to continue the experimentation with a precise question: the same or different macro and nano polymeric particles used for Sorafenib can convey new drugs such as second-line Lenvatinib (Regorafenib) or third line (Cabozantinib) belonging to the same class (tyrosine kinase inhibitors) and always with oral intake methods?