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The DeLIVER programme is running 3 clinical research studies (DELPHI, SELINA and PEARL) that aim to provide a better understanding on why changes within the liver (and in case of DELPHI also the bile ducts and pancreas) can lead to cancer and identify markers that detect liver cancer at the earliest stages when curative therapies may be applied. The clinical research studies recruit patients over the age of 18 years with liver conditions and/or liver cancer from NHS sites in the UK.

The DELPHI study is comparing the characteristics of immune cells found in Hepatocellular Carcinoma (HCC or liver cancer) and other cancer types to cells collected from individuals with no cancer. Cells are collected from cancer/non-cancer tissue using FNA (Fine-needle aspiration) or from blood, urine and bile. The aim of the study is to identify changes to the immune system that may be present in cancer but not in non-cancer patients and therefore may have the potential to either indicate the early development of cancer or could flag that an individual could be at risk of developing cancer.

The SELiNa study is recruiting patients with small early liver cancers to evaluate imaging and state-of-the art molecular biomarker tests and characterise the non-cancerous “background” liver to better understand the changes that may lead to cancer transformation. The aim is to assess if biomarkers can be used to predict disease progression by clinical follow-up. In addition, a subgroup of patients will also receive Magnetic Resonance (MR) liver Imaging in order to explore the possibility of using MR imaging as a tool for HCC diagnosis.

The Pearl study will recruit people with liver cirrhosis and follow them over a period of several years. As it is anticipated that a proportion of participants will develop liver cancer whilst enrolled in the study, blood and urine samples collected at multiple timepoints during the study will be used to verify whether any of the biomarkers and imaging markers identified in the SELiNa study can indeed detect HCC at an early stage.