Liver Cancer: Our Approach and Expertise

Each year, the Liver Cancer Program at Columbia University Medical Center/NewYork-Presbyterian Hospital cares for several hundred patients with these rare and challenging diseases. Our physicians have been recognized as the world’s leading experts on this condition, and we offer the broadest array of treatments including liver transplantation for hepatocellular and biliary cancers, local therapy approaches, and national leadership in clinical trials for advanced disease.

Our Program is known for providing

  • A comprehensive and multidisciplinary team approach to liver cancers involving best in class oncologists, pathologists, hepatologists, surgeons, clinical trialists and basic scientists
  • Personalized therapy based on the patient’s own genetic blueprint
  • A unique understanding of how liver cancers progress. Our NCI-sponsored prospective studies show how liver cancers manifests in different patients, helping us to determine the best way to manage each stage and each unique form of the disease.
  • Opportunities to participate in clinical trials—many of them designed by our physicians—offering access to the most advanced and innovative treatments
  • Ongoing research into the origin of cancer, the micro-environment in which abnormal cells first begin to grow, and identifying driver genetic mutations which can lead to the development of new therapies
  • Novel trials examining imaging biomarkers to predict response to therapies, and predictors of resistance earlier in the course of therapy using MRI spectroscopy, and Columbia-developed PET imaging technologies
  • A caring environment where we strive to treat each patient with warmth, integrity and respect
  • The only program in the region where members of all divisions of our group (oncologists, hepatologists, surgeons, and radiologists) are listed in NY Magazine for 2014 as the best in their fields, in addition to world class specialists in all fields of medicine
  • Medical advice on lifestyle, exercise, diet and nutrition
  • Psychological counseling and support groups
  • Consultation on pain management

Advances in Clinical Trials and Surgical Treatments

Our team is at the forefront of developing novel therapies for hepatobiliary cancers which help to characterize new biomarkers. Columbia led the first international multicenter trial of bevacizumab in hepatocellular carcinoma, and was one of the first to use imaging correlates to show that the drug worked to shut down the vascular supply to the tumor. We were the first to study the role of milk thistle in patients with advanced liver disease and liver cancer. Our center also recently completed the first multicenter trial examining the use of sorafenib in the post-transplant setting, effectively establishing the correct dose for the first time in this population. Columbia is also one of the few centers in the country that offers liver transplantation for selected patients with biliary and hepatocellular carcinomas, as well as ex-vivo resections that other surgeons are not trained to perform. Our group is currently collaborating closely with our radiology colleagues to develop new ways of detecting cancers, and predicting early responses to treatment so that patients do not remain on ineffective therapies longer than necessary.

Research into the Molecular Biology of Liver Cancers

Our researchers have been among the first to shed light on the relationship of different etiologies of liver cancer to certain pathologic subtypes of HCC. This has led to the discovery of a new pathologic entity known as the steatohepatitic variant of HCC. We currently have several projects ongoing examining the molecular signatures of hepatobiliary cancers to find specific treatments which may work best for certain subtypes. For instance, we have shown those with higher body mass index may have tumors with more aggressive features, and we are working to clarify the mechanisms and genetic targets behind these changes. We also have NIH, foundation, and industry support to examine how genetic and epigenetic changes in hepatobiliary cancers may be targeted by novel drugs with greater benefit and less toxicity than standard chemotherapies. Finally, we collaborate broadly with other institutions nationally and internationally to develop the best technologies which will ultimately help to improve hepatobiliary cancer treatments.

Research into the Epidemiology of Hepatobiliary Malignancies

Our group has published broadly on access to care both in New York and nationally for those with various subtypes of hepatobiliary cancers, including ways to increase access to vital surgical procedures including liver transplantation. We have also examined the role of inflammatory biomarkers in hepatobiliary cancers and more broadly to GI and cancers as a whole, again to help improve patient care. For instance, we were able to show that for most antioxidant supplements that are taken by patients, there is a u-shaped curve for overall survival, with benefits primarily seen in those who are deficient in that nutrient. Similarly, we found a blood marker showing higher levels of inflammation were associated with worsened survival in colon cancer, suggesting that perhaps this subgroup might be targeted for anti-inflammatory therapy. Our ongoing NCI-funded prospective epidemiologic and biomarker repository is a tremendous resource for future studies to help determine who will respond best to new targeted therapies.