Insight

Alessandro Vitale: Are We Missing Curative Opportunities in HCC Treatment?

Alessandro Vitale/LinkedIn

Aug 8, 2025, 15:19

Alessandro Vitale: Are We Missing Curative Opportunities in HCC Treatment?

Alessandro Vitale, Associate Professor of General Surgery at University of Padua, shared a post on LinkedIn about a recent article he and his colleagues co-authored published in Liver Cancer:

“Are we missing curative opportunities in HCC treatment?

Our international Converse Study, just published in Liver Cancer, highlights a striking gap:

16% of patients treated with Atezolizumab-Bevacizumab (AB) achieved a potential curative response
But only 3% actually underwent curative treatments

This discrepancy reveals a hidden and concerning phenomenon we define as under-conversion: patients who objectively respond to systemic therapy but are not redirected to potentially curative strategies such as resection, ablation, or transplantation.

What causes this?

Factors like centre expertise, presence of transplant programs, or multidisciplinary tumour boards may play a role—but not always. The decision to switch from palliative to curative intent requires more than tumour shrinkage: it demands a multiparametric re-evaluation grounded in clinical fitness, liver function, patient preferences, and institutional capability.

As systemic therapies evolve, so must our mindset.
Curative conversion is not just a theoretical concept—it may offer selected patients a chance for long-term survival, or even a drug-free future.

We believe it’s time to bring the concept of under-conversion into the clinical conversation. Let’s not miss the window of curability.”

Title: Conversion Ability of Immunotherapy in Hepatocellular Carcinoma: Insights from the International Converse Study

Authors: Alessandro Vitale, Jung Sun Kim, Giuseppe Cabibbo, Andrea Casadei-Gardini, Massimo Iavarone, Lorenza Rimassa, Francesca Romana Ponziani, Francesco Tovoli, Hong Jae Chon, Beodeul Kang, Chan Kim, Hiroshi Imaoka, Masafumi Ikeda, Masatoshi Kudo, Tomoko Aoki, Raffaella Tortora, Marco Guarracino, Bernardo Stefanini, Mariarosaria Marseglia, Alba Sparacino, Ciro Celsa, Mariangela Bruccoleri, Eleonora Alimenti, Fabio Marra, Claudia Campani, Sherrie Bhoori, Vincenzo Mazzaferro, Rodolfo Sacco, Antonio Facciorusso, Andrea Martini, Leonardo Stella, Lucia Cerrito, Hidenori Toyoda, Satoshi Yasuda, Federico Rossari, Margherita Rimini, Goki Suda, Takuya Sho, Gianluca Masi, Caterina Vivaldi, Tiziana Pressiani, Satoru Kakizaki, Atsushi Naganuma, Antonio Avallone, Anna Nappi, Gianpaolo Vidili, Caterina Soldà, Francesca Bergamo, David J. Pinato, Filippo Pelizzaro, Francesco Giuseppe Foschi, Alice Secomandi, Francesco Verderame, Enrico Bronte, Erika Martinelli, Donatella Marino, Sara Grasselli, Andrea Olivani, Maurizia Rossana Brunetto, Francesco Damone, Andrea Mega, Luca Marzi, Emiliano Tamburini, Matteo Ramundo, Piera Federico, Bruno Daniele, Edoardo G. Giannini, Andrea Pasta, Filomena Morisco, Maria Guarino, Celine Hoyek, Sara Boninsegna, Ajay Gupta, David Sacerdoti, Andrea Dalbeni, Irina Calvo Ramos, Jorge Adeva, Carlo Saitta, Concetta Pitrone, Maria Luisa Lentini Graziano, Nunzia Farella, Maria Rendina, Teresa Grassi, Maria Grazia Rodriquenz, Evaristo Maiello, José Presa, Inês Pinho, Yoichi Hiasa, Masashi Hirooka, Jocelin Chen, Gianluca Arrichiello, Carlo Aschele, Alessandro Furlanetto, Umberto Cillo