Decision-Making Biomarkers Guiding Therapeutic Strategies in Hepatocellular Carcinoma: From Prediction to Personalized Care
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Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Aichi, Japan
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Department of Hepatobiliary Cancer, Liver Cancer Research Center, Tianjin Key Laboratory of Digestive Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin’s Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Tianjin, China, Tianjin 300060, China
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Authors to whom correspondence should be addressed.
Cancers 2025, 17(19), 3105; https://doi.org/10.3390/cancers17193105
Submission received: 14 August 2025
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Revised: 18 September 2025
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Accepted: 18 September 2025
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Published: 24 September 2025
(This article belongs to the Special Issue Decision-Making Biomarkers in the Treatment of Hepatocellular Carcinoma)
Simple Summary
Hepatocellular carcinoma treatment has progressed with new systemic and surgical options. Combination immunotherapy improves outcomes for advanced disease but causes serious side effects, complicating treatment choices. Surgical approaches have expanded through conversion therapy and borderline resectability concepts, offering potential cures to more patients, though long-term effectiveness needs confirmation. This changing treatment environment makes biomarkers essential for guiding decisions. This review analyzes current predictive, prognostic, and treatment-response biomarkers, including molecular, immune, imaging, and blood-based types, stressing their role in selecting optimal strategies. By linking recent laboratory and clinical research discoveries, it aims to create a biomarker-driven framework for personalized patient care.
Abstract
Hepatocellular carcinoma (HCC) management has evolved remarkably with the advent of diverse therapeutic options, particularly systemic and surgical treatments. Combination immunotherapy has redefined the treatment paradigm for advanced HCC and contributed to improved patient outcomes. However, this brings forth challenges such as immune-related adverse events that complicate decision-making. Surgical strategies have expanded with the emergence of conversion therapy and borderline resectability, offering curative potential for a broader patient population. However, robust evidence of their long-term efficacy is lacking. Therefore, decision-making biomarkers have gained prominence across treatment modalities. This review explores the current landscape of predictive, prognostic, and treatment-response biomarkers in HCC, from molecular and immune signatures to radiological and biochemical markers, highlighting their role in optimizing therapeutic strategies. By integrating recent advances in basic and translational research with clinical practice, we aim to outline a biomarker-driven framework for individualized care in HCC.
