Overview

Led by principal investigator Lewis R. Roberts, M.B., Ch.B., Ph.D., the Hepatobiliary Cancer Laboratory studies primary liver cancers, including hepatocellular carcinoma, bile duct cancer (cholangiocarcinoma) and gallbladder cancer.

Our long-term objectives are to understand the molecular basis of these cancers and translate new research findings into improvements in prevention, early diagnosis, prognostic prediction and treatment of these cancers.

Incidence and progression of hepatobiliary cancers

The incidence of liver cancer and liver cancer death rates have been on the rise for years. In part because of the difficulty of early diagnosis of liver and biliary cancers, less than 1% of all patients are treated with potentially curative treatments, such as liver transplant or surgery.

The major causes of hepatocellular carcinoma include chronic infection with hepatitis B or hepatitis C; alcoholic cirrhosis; nonalcoholic fatty liver disease; dietary exposure to fungal aflatoxins; immune-related disorders such as primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis; and genetic disorders such as hemochromatosis and alpha-1-antitrypsin deficiency.

The incidence of hepatocellular carcinoma in the United States has increased markedly during the past 20 years, mostly due to the increase in chronic hepatitis C. As treatment for hepatitis C has improved and the prevalence of obesity and obesity-related fatty liver disease has increased in the United States, our lab is observing a major shift from hepatitis C to nonalcoholic fatty liver disease as the major cause of liver disease in the country.

Bile duct cancer (cholangiocarcinoma) also has been increasing worldwide, but with no clear explanation. There's a very strong association of cholangiocarcinoma with primary sclerosing cholangitis, an immune-mediated inflammatory disease.

Recent studies have found additional associations of cholangiocarcinoma with other chronic inflammatory diseases of the liver, such as cirrhosis, chronic viral hepatitis B and hepatitis C infection, alcohol use, and the metabolic syndrome spectrum, including diabetes.

Identifying cancer genes and inherited genetic risk

The genetic changes underlying the development and progression of hepatobiliary cancers are complex and incompletely understood.

Our lab is interested in the mechanisms by which cancers develop, grow and spread to other organs. Our research goals include identifying genes involved in these processes and determining strategies for better prevention, diagnosis and treatment hepatobiliary cancers.

Our research team is actively engaged in projects that are exploring the inherited tendencies of individuals and families toward the development of liver cancer and biliary tract cancers using the techniques of genome-wide association studies and whole-exome sequencing.

Bringing science to communities in need

Minnesota is home to some of the largest Somali, Hmong and Laotian populations in the United States. The prevalence of hepatitis B and hepatitis C infection is higher among these populations than among Caucasians, and our lab is collaborating and building strong relationships with these communities to address these health concerns.

In Minnesota, our lab is collaborating with the Somali Health Advisory Committee, an established community advisory board, and with Hepatitis B-Initiative, Minnesota (HBI-MN), a nonprofit organization that focuses on viral hepatitis screening in the Asian community.

We're developing culturally appropriate health education interventions for hepatitis B and hepatitis C, with a goal of decreasing the burden of chronic liver disease on these communities.

About Dr. Roberts

In addition to conducting research in the Hepatobiliary Cancer Lab, Dr. Roberts is a gastroenterologist at Mayo Clinic in Rochester, Minnesota, with expertise in the diagnosis and multidisciplinary management of benign and malignant liver masses, including hepatic adenomas, hepatocellular carcinomas, bile duct cancers (cholangiocarcinomas) and gallbladder cancers. Dr. Roberts is also a professor of medicine at Mayo Clinic College of Medicine and Science. His passion in research is to help advance individualized or personalized medicine to allow effective treatment of cancer with minimal side effects.