Role of Molecular Biomarkers in Liver Transplantation for Hepatocellular Carcinoma

Abstract

Patient selection and organ allocation for liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) relies predominantly on clinical parameters, such as tumor burden (ie, radiological imaging). Patients transplanted withinMilan criteria have outstanding outcomes with a 5-and 10-year survival of 70% and 55%, respectively. Tumor recurrence after transplantion is rare in these patients (10%); however, treatment options upon recurrence are generally limited, and outcomes are poor. There are also several studies showing how a subgroup of patients with tumors outside the Milan criteria might achieve comparable outcomes to patients within Milan criteria. In other words, the size and number of tumor nodules does not always reflect tumor biology, which could be better captured using molecular proxies for cancer aggressiveness. Over the last decade, we have significantly improved our understanding of the molecular landscape of early stage HCC. This includes the development of molecular classification, identification of prognostic and mutational signatures, and potential mechanisms of hepatocarcinogenesis. Some molecular markers have already proven useful to predict tumor-related outcomes in HCC patients after LT. Most of these analyses are limited to tissue-derived biomarkers, which limits their implementation in clinical practice because tissue biopsy is not required for HCC diagnosis. Minimally invasive alternative tools, such as liquid biopsy, are being increasingly explored and could help to individualize risk stratification for patients with HCC who will benefit from LT despite being outside the accepted clinical criteria.Liver Transplantation 26 823-831 2020 AASLD.

Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: case report and review of literature

“…Over the last decade, we have significantly improved our understanding of the molecular landscape of HCC [42]. Numerous studies have investigated the utility of molecular biomarkers, such as DNA alterations, to predict outcomes in patients following LT for HCC [42]. Circulating miRNA has emerged as one of the most attractive tools for the early diagnosis of cancers [42][43][44].…”

“…Numerous studies have investigated the utility of molecular biomarkers, such as DNA alterations, to predict outcomes in patients following LT for HCC [42]. Circulating miRNA has emerged as one of the most attractive tools for the early diagnosis of cancers [42][43][44]. Some authors have reported that miRNA markers were useful predictors of HCC recurrence after LT [42,[45][46][47].…”

“…Circulating miRNA has emerged as one of the most attractive tools for the early diagnosis of cancers [42][43][44]. Some authors have reported that miRNA markers were useful predictors of HCC recurrence after LT [42,[45][46][47]. In the near future, it is expected that the understanding of tumor biology will advance through further analysis of these molecular mechanisms, facilitating individual risk stratification for HCC patients who will benefit from LT [42].…”

Robust Biomarker Screening Using Spares Learning Approach for Liver Cancer Prognosis

“…The approaches employed to treat illness by gene therapy consist of gene replacement, gene restoration, gene extension, gene muzzling, vaccination, and, currently, gene-editing technology (Alsaggar and Liu, 2016;Chew et al, 2016;Karimian et al, 2019). Thus, the identification of a gene that can be used as a potential biomarker is an important step in the treatment of liver cancer (West et al, 2019;Zheng et al, 2019;Lu et al, 2020;von Felden and Villanueva, 2020).…”

Genomics and Prognosis Analysis of Circadian clock genes in Hepatocellular Carcinoma

“…Hepatocellular carcinoma (HCC) is one of the most frequent reasons of human abdominal malignancies-associated mortality worldwide (1). As the most prevalent kind of primary liver cancers, HCC accounts for over 70% of liver carcinomas(2), with its incidence increasing over the past several decades (3), which essentially results from hepatitis, alcohol abuse and several metabolic syndromes (4). The present tactics to HCC consist of radical treatments such as curative resection, liver transplantation for local lesions (5), and palliative therapies including ablation, chemotherapy et cetera (6).…”