A new report by Novotech, a global clinical Contract Research Organization (CRO), reveals a robust landscape of liver cancer research, with over 1,700 trials initiated globally since 2018. The "Liver Cancer – Global Clinical Trial Landscape" report highlights significant ongoing investment and treatment innovations aimed at improving outcomes for patients with this deadly disease, which is the sixth most diagnosed cancer worldwide and the third-most common cause of cancer-related deaths.
Regional Trial Activity
The report indicates that Asia-Pacific is at the forefront of liver cancer clinical trials, contributing 55% of the total, while North America accounts for 24%. Europe follows with 16%, and the rest of the world (ROW) contributes 5%. Mainland China, South Korea, Spain, and the United States are identified as top destinations for conducting these trials. This geographical distribution suggests varying regional approaches to clinical research, potentially influenced by factors such as funding, regulatory environments, and infrastructure.
Trial Phases and Focus
The trials span all phases, with a notable concentration on early and mid-phase trials (Phase I and II) in Asia-Pacific and North America. Europe and the ROW show a lower overall number of trials, which may reflect differences in regional research priorities or capabilities. Ongoing trials dominate globally, with Asia-Pacific leading in both ongoing and completed studies. North America and Europe demonstrate considerable activity in ongoing trials but fewer completed ones.
Treatment Landscape and Innovations
Hepatocellular carcinoma (HCC), the predominant form of liver cancer, accounts for approximately 90% of all cases. The treatment landscape for HCC is diverse and evolving. While surgical resection and liver transplantation offer the best long-term survival, many patients are unsuitable candidates due to tumor size or underlying liver conditions. Other treatments include traditional chemotherapy, targeted therapies (such as monoclonal antibodies and small molecules), and immunotherapies like immune checkpoint inhibitors (ICIs) or tyrosine kinase inhibitors (TKIs). First-line treatments often combine atezolizumab and bevacizumab, while second-line options include lenvatinib, sorafenib, regorafenib, and cabozantinib.
Funding and Investment
The funding landscape for liver cancer research reveals substantial support, particularly through public and venture capital funding. The United States ($4,898 million) and China ($3,131 million) have seen significant venture capital investments in liver cancer research between 2019 and 2023. Funding predominantly supports preclinical, Phase I, and Phase II stages, with lesser amounts allocated to discovery, Phase III, IND/CTA filed, and marketed stages.
Challenges and Opportunities
A SWOT analysis included in the report identifies strengths in multidisciplinary approaches and evolving therapies. Weaknesses include side effects and limited access to advanced treatments. Opportunities lie in precision medicine and immunotherapy, while threats include rising healthcare costs and insufficient funding for research. The report also notes that the Asia-Pacific region has a lower competing trial risk due to its large population and lower volume of studies, with a trial density four times lower than that of the US and about two times lower than Europe.
