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Editorial
. 2025 Apr 1;14(2):311-315.
doi: 10.21037/hbsn-2025-78. Epub 2025 Mar 25.

Advancing the management of hepatocellular carcinoma: surrogate markers and predictive biomarkers for survival on immunotherapy

Naoshi Nishida  1
Affiliations
Editorial

Advancing the management of hepatocellular carcinoma: surrogate markers and predictive biomarkers for survival on immunotherapy

Naoshi Nishida. Hepatobiliary Surg Nutr. .
No abstract available

Keywords: Hepatocellular carcinoma (HCC); immune checkpoint inhibitor (ICI); molecular targeted agent; surrogate markers; survival.

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Conflict of interest statement

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-2025-78/coif). The author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Application of surrogate markers and predicting biomarker for survival in immunotherapy of hepatocellular carcinoma. Early radiological response to atezolizumab plus bevacizumab combination therapy is reportedly associated with OS. Therefore, in cases of insufficient antitumor response, reconsideration of the therapeutic regimen may be necessary. Additionally, an early decline in AFP levels is correlated with favorable antitumor response and OS. In addition, efforts have also been made to utilize changes in ctDNA levels during treatment as a marker of tumor dynamics. Moreover, it is also reported that a lower NLR at the initiation of treatment has been linked to improved OS. Other promising biomarkers for predicting antitumor efficacy include the TRS, which is calculated based on pathological findings of tumor tissue, and estimations of the TME derived from omics analyses of tumor tissue. Furthermore, artificial intelligence algorithms based on omics data have been used to develop predictive score for survival such as the ABRS-P and the ISS10. These biomarkers hold promise for guiding decisions for treatment and optimizing the outcome of immunotherapy. AFP, alpha-fetoprotein; ABRS-P, Atezolizumab-Bevacizumab Response Signature-Prediction; ctDNA, circulating tumor DNA; ISS10, immune signature scores 10; mRECIST, modified response evaluation rriteria in solid tumors; NLR, neutrophil-to-lymphocyte ratio; OS, overall survival; OR, objective response; PD, progressive disease; PD-L1, programmed cell death-ligand 1; Teff; effector T cell; Treg; regulatory T cell; TRS, tumor risk score; TME, tumor immune microenvironment.
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References

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