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The SELINA study will recruit patients with early liver cancers as part of the DeLIVER programme aiming to detect liver cancer earlier.

The Small Early Liver cancer with Natural history (SELINA) study has recruited its first patients. In total, SELINA aims to recruit 250 patients with early-stage liver cancer from 8 NHS centres in England to identify biomarkers that can be used to detect liver cancer at the earliest possible time, and so increase the survival rate of this disease.

Liver cancer is the fastest rising cause of cancer death in the UK, with deaths increasing by 50% in a decade. One approach for improving survival is to detect these cancers earlier when treatments are more likely to be successful. However, current methods for detecting liver cancer are not sufficiently sensitive or specific to reliably pick up this cancer in its earliest stages and better, more sensitive techniques are needed.

The Cancer Research UK-funded DeLIVER programme is researching ways to detect liver cancer earlier. Led by Professor Ellie Barnes (Nuffield Department of Medicine), this multidisciplinary team of academic, clinical and industry partners are experts in a range of new detection technologies, including blood- and urine-based tests and clinical imaging. The SELINA cohort of patients with small liver cancers will enable the team to assess the ability of these technologies to detect very early cancers and compare how the different methods perform.


Liver cancer is commonly preceded by and co-occurs with cirrhosis, scarring of the liver that increases the risk of liver cancer. We want to understand what changes in the non-cancerous cirrhotic background liver cause cancer to develop and how cirrhosis affects the measurable clues for detecting liver cancer. To help us answer these questions, 200 of the SELINA participants will have liver cancer and cirrhosis, and 50 participants will have liver cancer without cirrhosis - Dr Emma Culver, Consultant Hepatologist and Clinical Lecturer (Oxford University Hospitals and the Nuffield Department of Medicine) and clinical lead for SELINA

After consenting to the study, blood, urine and tissue samples (where available) will be collected and will be compared to samples from people with cirrhosis but without cancer from the related Pearl clinical study. The researchers will look for cancer- and cirrhosis-associated changes in protein, antibody or metabolite levels and alterations in the levels of chemical modification of DNA by methylation using the TAPS assay developed in Oxford by Dr Chunxiao Song. Some patients will also undergo advanced types of MRI scans.


The SELINA study will allow us to make a direct comparison between different tests to see how good they are at detecting small liver cancers. The best performing technologies will then be taken forward for further investigation. We are grateful to all the participants for taking part in this important study. We hope that by improving the ability to detect liver cancer earlier, we will be able to save thousands of lives in the UK every year. - Professor Ellie Barnes, Chief Investigator for DeLIVER

This is the third of three clinical studies within the DeLIVER programme to start recruitment. The team opened the DELPHI study in March 2021 to gain a better understanding about the biology of liver cancer development. The Pearl study opened in February 2022 to follow people with high-risk conditions for liver cancer over 4 years until some of them develop cancer and assess whether the best performing technologies from SELINA can detect liver cancer at an earlier stage than current technologies.

Read more about the DeLIVER programme in the OxCODE liver cancer early detection research showcase and the DeLIVER website.

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