{Reference Type}: Journal Article
{Title}: Development and validation of a biomarker index for HCC treatment response.
{Author}: Liang J;Li PY;Norman J;Lauzon M;Yeo YH;Trivedi H;Ayoub WS;Kuo A;Friedman ML;Sankar K;Gong J;Osipov A;Hendifar A;Todo T;Kim I;Voidonikolas G;Brennan TV;Wisel SA;Steggarda J;Kosari K;Saouaf R;Nissen N;Yao F;Mehta N;Yang JD;
{Journal}: Hepatol Commun
{Volume}: 8
{Issue}: 7
{Year}: 2024 Jul 1
{Factor}: 5.701
{DOI}: 10.1097/HC9.0000000000000466
{Abstract}: <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.