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Fatty Acid Degradation (FAD) Subtype-Informed Treatment Allocation in Unresectable Hepatocellular Carcinoma
Yuan Cheng1, Binghua Li2, Decai Yu2
1Department of Medical Oncology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, People's Republic of China.
Journal of Hepatocellular Carcinoma
|May 21, 2026
Summary
This study investigates if fatty acid degradation (FAD) subtypes can guide treatment for unresectable hepatocellular carcinoma (HCC). FAD-based stratification may personalize therapy, improving outcomes for HCC patients.
Area of Science:
- Hepatocellular carcinoma (HCC) research
- Cancer metabolism and immunotherapy
Background:
- HCC exhibits heterogeneity impacting treatment response.
- Current biomarkers for unresectable HCC are lacking.
- Fatty acid degradation (FAD) signatures define HCC subtypes with distinct immune profiles.
Purpose of the Study:
- To prospectively evaluate FAD-based metabolic subtyping for guiding treatment allocation in unresectable HCC.
- To assess the feasibility and preliminary clinical activity of FAD-informed treatment strategies.
- To support the development of biomarker-guided precision medicine in HCC.
Main Methods:
- Prospective, multicentre, Phase II study (FAD-HCC-01).
- Tumor transcriptomic profiling to determine FAD subtype (F1/F2 vs. F3).
- Treatment allocation based on FAD subtype: F1/F2 receive camrelizumab + rivoceranib; F3 receive TACE + camrelizumab + rivoceranib.
Main Results:
- Primary endpoint: objective response rate (RECIST v1.1).
- Secondary endpoints include survival, response duration, and safety.
- Exploratory analysis of MRI proton density fat fraction concordance with FAD classification.
Conclusions:
- This study will prospectively assess FAD-based subtyping for treatment allocation in unresectable HCC.
- Results may provide evidence for metabolism-informed precision therapy.
- Findings could inform future biomarker-guided clinical trial designs.
