Mark Yarchoan: Does the Barcelona HCC Classification Still Reflect Current Treatment Practice in North America?

A new system for classifying hepatocellular carcinoma (HCC), called BEACON-HCC, was introduced at the HCC-LIVE meeting and is now available for public comment. This development comes as current staging methods may be struggling to keep pace with rapidly evolving treatment options for this type of liver cancer.

A New Approach to HCC Staging

The Barcelona HCC classification has long been a standard for assessing the stage of HCC, but questions have arisen regarding its continued relevance in light of new therapies. Mark Yarchoan, Associate Professor at Johns Hopkins Hospital and Co-Founder and CSO at Adventris Pharmaceuticals, questioned whether the Barcelona HCC classification still reflects current treatment practise in North America.

How BEACON-HCC Differs

Initial testing of BEACON-HCC demonstrates a high degree of agreement among experts – 100% concordance in pilot cases. This contrasts sharply with the 2022 BCLC framework, which showed expert agreement in only 58.6% of cases. Key differences driving this improved concordance include:

A more detailed consideration of the extent of the tumor within the liver and whether it has invaded blood vessels.
The inclusion of biomarkers, such as alpha-fetoprotein (AFP), to assess tumor biology.
Recognition of increasingly common treatments in North America, including external beam radiation therapy (EBRT), transarterial radioembolization (TARE) and combinations of systemic and local therapies.

Did You Know? The BEACON-HCC classification was introduced for public comment at the HCC-LIVE meeting.

According to Yarchoan, as more treatment options become available for HCC, staging systems must adapt to accurately reflect the complex, multidisciplinary decisions made by healthcare teams.

Expert Insight: The development of BEACON-HCC highlights the dynamic nature of cancer staging. As treatment landscapes shift, the tools used to assess disease progression and guide clinical decisions must also evolve to ensure patients receive the most appropriate care.

What Could Happen Next

The introduction of BEACON-HCC for public comment is a crucial first step. Feedback from the medical community could lead to refinements of the classification system. If widely adopted, BEACON-HCC may become a new standard for HCC staging in North America. It is also possible that the Barcelona HCC classification will be updated to incorporate the elements highlighted in BEACON-HCC. Further research may be conducted to validate the effectiveness of BEACON-HCC in predicting treatment outcomes and improving patient care.

Frequently Asked Questions

What is HCC?

Hepatocellular carcinoma (HCC) is a type of liver cancer.

What is staging in cancer?

Staging is a process used to determine the extent of cancer in the body, which helps guide treatment decisions.

What are the current staging systems for HCC?

The Barcelona HCC classification and the 2022 BCLC framework are staging systems for HCC.

How might more accurate staging impact patient care?