Dr. Pinato on Biomarker Challenges in HCC

David J. Pinato, MD, PhD, clinical senior lecturer in medical oncology, clinician scientist, consultant medical oncologist, Department of Surgery and Cancer, Imperial College London, discusses the lack of biomarkers in hepatocellular carcinoma (HCC).

Since the FDA approval of sorafenib (Nexavar) in 2007 for the treatment of patients with unresectable HCC, there had not been a novel therapy introduced to the treatment paradigm, says Pinato. As such, there was little clinical reason to biopsy patients as most of them received the same therapy.

Additionally, there are multiple subtypes of HCC, says Pinato. However, unlike ALK-positive non­—small cell lung cancer, for example, these subtypes are largely descriptive and lack actionable biomarkers that drive HCC progression.

Lastly, most institutions have abandoned performing routine biopsies for patients with HCC based on radiologic criteria, explains Pinato. Patients were not biopsied because there were limited therapy options, which led to a lack of molecular knowledge in HCC, which ultimately led to a lack of biomarker development, concludes Pinato.