%0 Journal Article
%T Development and validation of a biomarker index for HCC treatment response.
%A Liang J
%A Li PY
%A Norman J
%A Lauzon M
%A Yeo YH
%A Trivedi H
%A Ayoub WS
%A Kuo A
%A Friedman ML
%A Sankar K
%A Gong J
%A Osipov A
%A Hendifar A
%A Todo T
%A Kim I
%A Voidonikolas G
%A Brennan TV
%A Wisel SA
%A Steggarda J
%A Kosari K
%A Saouaf R
%A Nissen N
%A Yao F
%A Mehta N
%A Yang JD
%J Hepatol Commun
%V 8
%N 7
%D 2024 Jul 1
%M 38896084
%F 5.701
%R 10.1097/HC9.0000000000000466
%X <B>BACKGROUND: </B>Serum AFP-L3%, AFP, and DCP are useful biomarkers for HCC detection, but their utility in assessing treatment response remains unknown. We aim to evaluate the accuracy of a biomarker model in the detection of posttreatment viable tumors.<BR><B>METHODS: </B>For model derivation, recipients with HCC undergoing liver transplant from 2018 to 2022 who had biomarkers collected within 3 months before transplant were included. We developed a generalized linear model for detecting posttreatment viable tumors with the 3 biomarkers as covariates, which we termed the "LAD Score." An independent cohort of 117 patients with HCC was used for external validation.<BR><B>RESULTS: </B>Among 205 recipients of transplant, 70.2% had evidence of viable tumor on explant. The median LAD score was higher among patients with viable versus nonviable tumors (1.06 vs. 0.465, p < 0.001). The LAD score had a sensitivity of 55.6% and a specificity of 85.1% at the cutoff of 0.927, which was more accurate than imaging for detecting posttreatment viable tumors (AUROC 0.736 vs. 0.643, respectively; p = 0.045). The superior performance of the LAD score over imaging is primarily driven by its greater accuracy in detecting tumors <2 cm in diameter (AUROC of the LAD score 0.721 vs. imaging 0.595, p = 0.02). In the validation data set, the LAD score had an AUROC of 0.832 (95% CI: 0.753, 0.911) with a sensitivity of 72.5% and a specificity of 89.4% at the cutoff of 0.927.<BR><B>CONCLUSIONS: </B>Our findings suggest the utility of LAD score in treatment response assessment after locoregional therapy for HCC, particularly in detecting small tumors. A larger prospective study is in progress to validate its accuracy and evaluate its performance in recurrence monitoring.