ABSTRACT
Introduction: Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and the third largest cause of cancer-relateddeaths worldwide. Potentially curative treatments (surgical resection, radiofrequency or liver transplantation) are only available for few patients, while transarterial chemoembolization (TACE) or systemic agents are the best treatments for intermediate and advanced stage disease. The identification of markers that allow us to choose the best treatment for the patient is urgent.
Areas covered: In this review we summarize the potential biological markers to predict the efficacy of all treatment available in patients with HCC and discuss anew biomarker with ahigher potential of success in the next future.
Expert opinion: HCC is aheterogeneous disease. Tumors are heterogeneous in terms of genetic alteration,with spatial heterogeneity in cellular density, necrosis and angiogenesis.This heterogeneity may affect prognosis and treatment. Tumor heterogeneity can be difficult to quantify with traditional imaging due to subjective assessment of images; the same for sampling biopsy, which evaluates only asmall part of the tumor. We think that combining multi-OMICSwith radiomics represents apromising strategy for evaluating tumor heterogenicity and for identifying biomarkers of response and prognosis.
ARTICLE HIGHLIGHTS
HCC is a complex and multifaceted disease, with a poor prognosis in the advanced stage
Sorafenib has been the only drug approved for the treatment of patients with advanced HCC for many years, but the treatment landscape is rapidly expanding
Many biological markers have been evaluated in order to predict the efficacy of all treatment available, but at present, there is not a single biomarker allowing us to define the best treatment for each specific patient
Other potential new biomarkers are under exploration, as the so-called OMICS revolution, Radiomics, Liquid Biopsy
In this context, combining multi-OMICS with radiomics could represent a promising and ground-breaking strategy
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Correction Statement
This article has been republished with minor changes. These changes do not impact the academic content of the article.