PETALING JAYA, 4 November 2020 - Immunotherapy is one of the newer cancer treatment options that helps people with cancer to use their immune system to fight cancer1. This innovative treatment option has revolutionized the cancer treatment landscape2, especially for liver cancer.
Liver cancer, or hepatocellular carcinoma (HCC), is one of the leading causes of death globally3, accounting for more than 700,000 deaths every year4. In Malaysia, it is the 6th most common cancer3 and the 4th most common cancer deaths5.
Primary liver cancer is a cancer that begins in the cells of your liver6 and HCC is the most common type of primary liver cancer. Up to 90% of liver cancers occur in patients with cirrhosis, with most commonly resulting from chronic liver diseases such as hepatitis B virus or hepatitis C virus, nonalcoholic fatty liver disease (NAFLD), excessive alcohol consumption, etc6.
People with liver cancer may not experience distinctive symptoms during the early stages7. Some of the symptoms that people with liver cancer experience at the later stages include unintentional weight loss, upper abdominal pain, loss of appetite, nausea and vomiting, abdominal swelling, yellow discoloration of skin and the whites of the eyes.6 This makes early detection and timely treatment very challenging for liver cancer. If discovered early, liver cancer can probably be cured7. Unfortunately, not many who are at risk of liver cancer are aware of this.
The number of liver cancer related deaths continue to increase globally. Cirrhosis, the most common cause of liver cancer is one of the top 10 causes of deaths in Malaysia in 20198. "We need to address this urgently and collaborative efforts from all parties - the government, public and private health sectors play an imperative role in preventing this situation from worsening. It is important for those who are in the high-risk groups to undergo screening or surveillance for liver cancer to allow early detection and timely treatment. The earlier the diagnosis, the better the prognosis and treatment outcomes,” said Professor Dr Rosmawati, Consultant Hepatologist at University of Malaya Medical Centre (UMMC), at the “Let’s Learn about Liver Cancer” media workshop held recently to improve liver cancer awareness in the country.
There are several treatment options which have been shown to improve survival of patients with liver cancer include surgery, local ablative therapy, and systemic therapy in the forms of, targeted therapy and immunotherapy.
Immunotherapy is one of the newer cancer treatment options that helps people with cancer to use their immune system to fight and destroy cancer cells1. When a person has cancer, the body’s disease-fighting immune system may not attack the cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process9.
Immunotherapy may be more effective to treat certain types of cancer, especially cancers that have been resistant to chemotherapy and radiation therapy. Not just that, it may offer the possibility of long-term cancer remission. This is because it can train the immune system to recognise cancer cells. Considering that immunotherapy is focused on the immune system, it may not cause the same side effects as the conventional treatment options, such as chemotherapy and radiation therapy10.
Immunotherapy can be used alone or in combination with other treatment options, such as anti-VEGF to improve their effectiveness11. This immunotherapy combination regimen improves the overall survival and progression-free survival, compared to the previous standard of care. Not just that, it may enhance the potential of the immune system to combat a broad range of cancers12.
“Combining immunotherapy with other treatments gives people with liver cancer new opportunities. We have seen its efficacy from some of the global studies. Personally, I am excited and looking forward to seeing how else immunotherapy can help cancer patients,” concluded Professor Dr. Rosmawati.
“We at Roche are committed to tackling liver disease right across the disease journey, from the earliest stages through to advanced disease, with the ultimate goal of one day stopping chronic liver disease. Not only are we passionate about transforming patients’ lives and developing innovations for the future, the patient is and will remain at the core and everything of what we do. We truly believe in our contribution to science and doing now what patients need next,” said Lance Duan, General Manager, Roche Malaysia.
The advancement in the healthcare industry has transformed the cancer treatment landscape in recent years, offering better efficacy, improved quality of life and prolonged survival rates. It is important for those with cancer to discuss with their doctors to choose the most suitable treatment option.
Cancer.gov. Immunotherapy to treat cancer. Available at
Wiley Online Library. Immune landscape of hepatocellular carcinoma microenvironment: implications for prognosis and therapeutic applications. Available at
Ministry of Health. Malaysia National Cancer Registry Report 2012-2016. (pg. 17, 39)
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6): 394–424. Available at
The Global Cancer Observatory October 2020. Factsheet. Available at
Mayo Clinic. Liver Cancer Overview. Available at
Healthline. What are the symptoms of hepatocellular carcinoma? Available at
Institute for Health Metrics and Evaluation (IHME). Malaysia. Available at
Mayo Clinic. Liver Cancer, Diagnosing liver cancer. Available at
Cancer Research Institute. Benefits of cancer immunotherapy. Available at
Cancer Research Institute. What is Immunotherapy? Available at
BMJ Journals. Immunotherapy for advanced hepatocellular carcinoma: a focus on special subgroups. Available at
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