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WASHINGTON -- The annual Liver Meeting always draws a crowd, largely because there's pretty much something for everyone with an interest in hepatology.
"We don't have a specific theme because we have to cover every aspect of liver development," according to of the University of Michigan in Ann Arbor, president of the , which sponsors the meeting.
"This is where we share the latest in science, where we network, and where we promote the training and development of our young investigators," Lok told 51˶ in advance of the five-day meeting here.
"Each meeting we expect that there will be novel data that will be presented that could potentially change the field," she said.
That's not to say there haven't been times when one aspect of liver disease took the lion's share of attention, Lok noted. "In the past few years that has always been hepatitis C" (HCV), when each meeting seemed to showcase "another new marvelous drug" if not several.
There remains a great deal of interest in HCV, evidenced by dozens of posters and oral presentations on new therapeutics, as well as on other aspects of the disease. Indeed, organizers are planning a special session on the path to elimination of viral hepatitis, featuring a talk by U.S. Surgeon General Jerome Adams, MD. Adams will discuss the opioid crisis and the related epidemics of HIV and HCV.
But Lok said she expects to see the focus shift to some intriguing new science in other areas -- fatty liver, cancer, hepatitis B, and cholangitis, among others.
In some cases, the advances will include important trials of new drugs -- in fatty liver, for instance, both obeticholic acid (approved for primary biliary cholangitis) and an acetyl CoA carboxylase are under investigation and researchers will present new data here.
In other cases, novel approaches are being highlighted. For instance, transplant investigators examined the possibility of splitting donor livers, and using a small section in a pediatric patient with the remainder going to an adult. Such an approach could ease the shortage of livers for young patients needing a transplant.
As well, researchers are looking at whether organs once thought to be unsuitable -- perhaps because of a past HCV infection or ischemic damage -- might be usable after all.
For liver cancer, Lok said, new drugs are under development and she expects to see results from several phase II trials. "You have to have personalized treatment," she said. "There are different pathways that lead to cancer, and not all cancers are alike, so you can't have drugs that work on one pathway only."
"We expect a few new trials, new data, which is important because liver cancer is also on the rise in the U.S.," Lok said.
She added there is a "major resurgence of interest in hepatitis B" although almost all of the research at this meeting will be in the early stages of development with "nothing moving to phase III yet."
There is treatment and a vaccine but no cure for chronic HBV. Nevertheless, Lok said, "Everybody wants to be cured. One reason people are getting back into hepatitis B research is that they are hearing from patients: 'You can cure hepatitis C, why can't you cure hepatitis B?'"
"It's a different virus and it's more complicated," Lok added, but investigators are no longer satisfied just to find better treatments. "The goal is to shoot for the gold medal if you can," Lok said. "No one is shooting for the bronze medal."