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Research Areas
Dr. Marrero's research interest involves strategies
for the early detection, identification of risk factors
and novel therapies for hepatocellular carcinoma (HCC).
HCC is the tumor with the largest increase in incidence
over the last 10 years and it is projected to continue
to increase. The rise in the incidence of this tumor
is attributed to the hepatitis C epidemic. Most of
the patients are diagnosed at advanced stages, so
strategies for the early detection of this tumor are
important.
Liver and its adjacent organs
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The arrow illustrates a mass in the liver that on biopsy is consistent with a hepatocellular carcinoma
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To this end, Dr. Marrero is an associate member of
the National Cancer Institute's Early Detection Research
Network (EDRN). This group has the infrastructure
and expertise in the discovery and validation of novel
biomarkers for various solid tumors. Dr. Marrero and
colleagues have tested a protein named des-gamma carboxyprothrombin,
which has been shown to be elevated in these patients.
A cross-sectional study has found that this marker
has a better sensitivity and specificity than the
clinically available tumor marker alpha-fetoprotein
(AFP). Another biomarker that Dr. Marrero has studied
with colleagues from Thomas Jefferson University is
Golgi Protein 73, which also appears to have a better
sensitivity and specificity than AFP. In addition,
Dr. Marrero and colleagues have shown that protein
profiling using SELDI-TOF technology can differentiate
patients with HCC from those without cancer. Dr. Marrero
has competed successfully for an NIH grant for the
validation of the above mentioned markers.
Even though chronic liver disease is a risk factor
for developing HCC, this tumor will not develop in
all patients with liver disease. So, Dr. Marrero is
also interested in the identification of risk factors
important for the development of this tumor. In a
recent cross-sectional study, Dr. Marrero showed that
lifelong alcohol and tobacco exposure as well as obesity
increases the risk for developing HCC. Interestingly,
these factors interacted synergistically to increase
the risk of HCC in patients with chronic liver disease.
These data may help stratify those at the highest
risk for HCC in order to provide screening.
Another research interest of Dr. Marrero is the study
of novel therapeutic agents for HCC. He has completed
a clinical trial for the treatment of HCC using the
novel agent tetrathiomolybdate, which by causing copper
depletion inhibited the process of angiogenesis in
11 patients with advanced HCC. Responses to the treatment
have been observed already. Dr. Marrero and colleagues
have also developed a new model to assess tumor vascularity
by MRI to quantify the angiogenic process in these
patients. They are entering the latter stages of this
study now and are awaiting the final results. This
study is quite exciting because besides liver transplantation
there are no other therapies that have been shown
to improve survival, and it is hoped that by inhibiting
the process of angiogenesis we will be offering an
option that will improve survival in these patients.
Study Projects
- Dr. Marrero is conducting an NIH-funded trial
for the validation of novel tumor markers. We are
enrolling patients with cirrhosis of the liver without
HCC and patients with early stage HCC. This study
will help us determine if novel tumor markers are
better than AFP for the detection of early stage
HCC.
- Dr. Marrero is conducting an NIH trial to observe
the incidence of HCC. Patients with cirrhosis and
no tumor are enrolled and followed prospectively
over a 5-year period to determine the number of
patients that developed HCC. We are collecting serum
for the future validation of novel biomarkers.
Publications Please
click here
for a list of publications by Dr. Marrero.
Honors/Awards
- Janssen Scholar Fellow
- Alpha Omega Alpha
- ADHF Fellow/Faculty Transition Award
- AASLD Advanced Hepatology Fellow Award
- AGA Clinical Research Career Development Award
- ACG Junior Faculty Career Development Award
- UIC Digestive and Liver Disease Research Award
- Research Excellence in Gastroenterology and Liver (REGAL) Award
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