Laboratory predictors of treatment response in hepatocellular carcinoma

Czech version

Authors: P. Hříbek ; T. Jurčová; A. Drastich ; M. Tomáš ; P. Urbánek
Authors‘ workplace: Interní klinika 1. LF UK a ÚVN – VFN Praha
Published in: Gastroent Hepatol 2026; 80(5): 384-389
Category: Gastrointestinal Oncology: Review Article
doi: https://doi.org/10.48095/ccgh2026384

Overview

Hepatocellular carcinoma (HCC) is a malignancy with poor prognosis. With the expanding range of systemic and locoregional treatment options, there is an increasing need for biomarkers that enable early and objective assessment of the treatment response and support individualized treatment. This review summarizes current laboratory biomarkers measured in peripheral blood for predicting the therapeutic response in HCC, evaluates their clinical relevance and limitations, and outlines possible direction for future development. At present, no validated laboratory predictive biomarker reliably enables selection of a specific systemic treatment for an individual patient. Alpha-fetoprotein (AFP) remains the most widely used serum biomarker. Although baseline AFP concentration is predominantly prognostic, an early decline in AFP after treatment initiation is associated with a higher probability of radiological response and longer survival. Inflammatory indices, particularly the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index, appear to have a predominantly prognostic value. The CRAFITY score may have predictive potential in patients receiving immunotherapy, although further validation is required. The albumin-bilirubin (ALBI) score primarily reflects hepatic functional reserve and is predominantly prognostic rather than predictive of the treatment response. Blood plasma spectroscopy represents a promising experimental approach for very early detection of the therapeutic response. Reliable validation of laboratory predictive biomarkers remains essential for further individualization of HCC treatment and for realizing the full potential of increasingly diverse therapeutic strategies.

Keywords:

precision medicine – immunotherapy – biomarkers – hepatocellular carcinoma – spectroscopy

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