Predictive Biomarkers of Antiangiogenic Therapy for Advanced Hepatocellular Carcinoma: Where Are We?

Abstract

Antiangiogenic therapy, especially treatment with sorafenib, is the primary treatment for patients with advanced hepatocellular carcinoma (HCC). However, the efficacy of such therapy is modest, with low objective response rates and limited prolongation of survival times. Several researchers have investigated predictive biomarkers to help identify patients who can benefit most from antiangiogenic therapy. The largest study on this topic to date was based on the pivotal phase III study of sorafenib (the SHARP study) and did not find any plasma markers that could predict the efficacy of sorafenib. Other studies based on single-arm phase II clinical trials found some potential predictive markers, such as early alpha-fetoprotein response, the serum insulin-like growth factor-1 level at baseline, and the volume transfer constants of dynamic contrast-enhanced magnetic resonance imaging. These findings require validation by further studies. Identifying predictive biomarkers of antiangiogenic therapy for HCC remains challenging and warrants further investigations.

Evaluation of antiangiogenic efficacy in advanced hepatocellular carcinoma: Biomarkers and functional imaging

“…However, scant data is/are available regarding the value of AFP-L3 as predictive of response to antiangiogenic agents in HCC [78] . In summary, available data are not consistent enough to confirm the value of baseline AFP level as a predictive marker of response to antiangiogenic treatment for patients treated for advanced HCC [79] .…”

High Serum Transforming Growth Factor-β1 Levels Predict Outcome in Hepatocellular Carcinoma Patients Treated with Sorafenib

“…The median time to disease progression in Western and Asian patients was only 4.1 and 2.8 months, respectively (1,2). Factors that could predict the treatment efficacy of sorafenib or enable stratifying advanced HCC patients according to prognosis are urgently required, but have yet to be determined despite extensive exploration (3).…”

GTSF1 gene may serve as a novel potential diagnostic biomarker for liver cancer

“…The identification of cancer-associated molecules may lead to the development of novel molecular targets for treatment, and of biomarkers for predicting prognosis (11). The various etiological factors of HCC, including HBV infection and hepatitis C virus infection, may affect different signaling pathways (12). Therefore, multiple genetic and epigenetic factors may affect HCC development (13).…”