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Blood-based biomarkers for immune-based therapy in advanced HCC: Promising but a long way to go
Pil Soo Sung1,2, Isaac Kise Lee3, Pu Reun Roh1
1Department of Biomedicine and Health Sciences, The Catholic University Liver Research Center, College of Medicine, POSTECH-Catholic Biomedical Engineering Institute, The Catholic University of Korea, Seoul, South Korea.
Abstract:
The introduction of immune checkpoint inhibitors (ICIs) represents a key shift in the management strategy for patients with hepatocellular carcinoma (HCC). However, there is a paucity of predictive biomarkers that facilitate the identification of patients that would respond to ICI therapy. Although several researchers have attempted to resolve the issue, the data is insufficient to alter daily clinical practice. The use of minimally invasive procedures to obtain patient-derived specimen, such as using blood-based samples, is increasingly preferred. Circulating tumor DNA (ctDNA) can be isolated from the blood of cancer patients, and liquid biopsies can provide sufficient material to enable ongoing monitoring of HCC. This is particularly significant for patients for whom surgery is not indicated, including those with advanced HCC. In this review, we summarize the current state of understanding of blood-based biomarkers for ICI-based therapy in advanced HCC, which is promising despite there is still a long way to go.
Insights
Predicting response to immune checkpoint inhibitors (ICIs) in liver cancer (HCC) is challenging. Blood-based biomarkers, like circulating tumor DNA (ctDNA), show promise for identifying patients who will benefit from ICI therapy in advanced HCC.
Area of Science:
- Hepatobiliary Oncology
- Immunotherapy
- Molecular Diagnostics
Background:
- Immune checkpoint inhibitors (ICIs) have transformed hepatocellular carcinoma (HCC) treatment.
- Predictive biomarkers for ICI response in HCC are lacking, hindering personalized treatment strategies.
- Minimally invasive methods for obtaining patient samples are increasingly favored.
Purpose of the Study:
- To review the current understanding of blood-based biomarkers for ICI therapy in advanced HCC.
- To highlight the potential of liquid biopsies and circulating tumor DNA (ctDNA) in this context.
Main Methods:
- Literature review of studies on blood-based biomarkers for ICI therapy in HCC.
- Focus on circulating tumor DNA (ctDNA) analysis from liquid biopsies.
- Analysis of biomarker utility in advanced HCC, especially for non-surgical candidates.
Main Results:
- Current data on predictive biomarkers for ICI therapy in HCC is insufficient for clinical practice.
- Liquid biopsies offer a minimally invasive approach for monitoring advanced HCC.
- Circulating tumor DNA (ctDNA) shows potential as a blood-based biomarker for ICI response.
Conclusions:
- Blood-based biomarkers, particularly ctDNA, hold promise for guiding ICI therapy in advanced HCC.
- Further research is needed to validate these biomarkers and integrate them into clinical practice.
- Liquid biopsies represent a valuable tool for ongoing monitoring in HCC patients ineligible for surgery.
