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Updated: Oct 1, 2025
Author Spotlight: Investigating Immune Cell Dynamics in the Tumor Microenvironment — Challenges and Innovations in Cancer Prognosis
Published on: April 12, 2024
Predictive biomarkers of response to immune checkpoint inhibitors in hepatocellular carcinoma
Ambreen Muhammed1, Antonio D'Alessio1,2, Andrei Enica1
1Department of Surgery & Cancer, Imperial College London, London, UK.
Introduction:
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and fourth-leading cause of cancer death. While drug discovery to improve disease survival was historically poor, there is now evidence of significant potential for immune checkpoint inhibitors (ICPIs) in treatment of the disease, and indeed such drug approvals are beginning to emerge.
Areas Covered:
HCC typically arises in the context of cirrhosis and chronic liver disease (CLD), and HCC exhibits significant biological heterogeneity, in part reflecting the broad range of etiologies of CLD. Different classes and combinations of ICPI-based therapy exist, but not all patients will respond and predictive biomarkers are not yet available to guide clinician decision-making, unlike some other cancer types. In this review, we discuss the emerging biomarkers for ICPI sensitivity in HCC, including tumor genomic features, perturbation of the gut microbiome, and systemic inflammatory markers.
Expert Opinion:
Additional profiling studies are required to appreciate existing trends with clinical outcome and to further drive clinical studies in disease stratification by response. This will only be possible within collaborative and international efforts, especially regarding biopsy collection. A close collaboration between basic scientists and clinicians will be the key to shape the next future of HCC biomarker research.
Insights
Hepatocellular carcinoma (HCC) treatment shows promise with immune checkpoint inhibitors (ICPIs). Emerging biomarkers, including genomic features and microbiome data, may predict patient response to these novel therapies.
Area of Science:
- Oncology
- Immunology
- Hepatology
Background:
- Hepatocellular carcinoma (HCC) is a leading cause of cancer death, often arising from chronic liver disease (CLD).
- Traditional drug discovery for HCC has yielded limited survival benefits.
- Immune checkpoint inhibitors (ICPIs) represent a promising new therapeutic avenue for HCC.
Purpose of the Study:
- To review emerging biomarkers for predicting ICPI sensitivity in HCC.
- To highlight the need for further research and clinical studies in biomarker development for HCC.
Main Methods:
- Review of current literature on HCC biomarkers and ICPI therapy.
- Discussion of tumor genomic features, gut microbiome, and systemic inflammatory markers as potential biomarkers.
- Analysis of the role of collaborative efforts in advancing biomarker research.
Main Results:
- ICPIs are demonstrating significant potential in HCC treatment, with approvals emerging.
- HCC exhibits biological heterogeneity linked to diverse CLD etiologies.
- Biomarkers for ICPI sensitivity are crucial for guiding clinical decision-making but are not yet widely available.
Conclusions:
- Further profiling studies are essential to correlate biomarker trends with clinical outcomes.
- International collaboration and extensive biopsy collection are vital for advancing HCC biomarker research.
- Close collaboration between basic scientists and clinicians is key to future HCC biomarker discovery.
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