Studying a potential new approach to treating cancer in the liver

Dr. Gonzalo Sapisochin

Transplant surgeon Dr. Gonzalo Sapisochin (Photo credit: UHN)

Surgeons at Toronto General Hospital have begun a research study to determine if living donor liver transplantation is an effective treatment for colorectal cancer that has spread to the liver.

The first patient in this study underwent chemotherapy treatment, followed by a living donor liver transplant. Both the donor and recipient are doing well two months after transplantation.

The innovative study, led by transplant surgeon Dr. Gonzalo Sapisochin and supported by Toronto General & Western Hospital Foundation (TGWHF) donors, will recruit approximately 20 patients who have colorectal cancer that has spread to the liver, and who are being treated with chemotherapy. The study is currently recruiting patients.

A new era in transplant oncology

Dr. Sapisochin explains that advances in transplant surgical techniques, imaging, chemotherapy, standardized patient selection and post-operative care have all combined to “push the envelope of what treatments we can offer patients with cancer which is confined to the liver.”

“We think that pre-transplant chemotherapy, careful monitoring of tumours, and living donation will give our patients better results,” says Dr. Sapisochin. “This is a new era of transplant oncology.”

Colorectal cancer is the second most commonly diagnosed cancer in Canada and the second leading cause of cancer death. On average, about 70 Canadians are diagnosed with this cancer every day. Cancer spread to the liver occurs in about half of all patients.

Although surgical removal of the liver cancer is possible, only 20 per cent to 40 per cent of patients are candidates for this surgery. For those who can’t undergo surgery, palliative chemotherapy is the only option, with a survival rate of less than 10 per cent to 20 per cent at five years. This opens the potential for another treatment option.

The study is based at the UHN Centre for Living Organ Donation, established with funding from TGWHF donors in 2018. After transplantation, participants will be followed for five years to test longevity, to see if they remain cancer-free, and to determine best treatments should the cancer reoccur. Researchers aim to publish their initial outcomes in 2020. ​