Using AFP as a Biomarker in HCC

EP: 1.Challenges in the Management of Advanced HCC

EP: 2.First-line Locoregional Therapies in Advanced HCC

EP: 3.Patient Assessment for TACE in Unresectable BCLC Stage B HCC

EP: 4.Practical Considerations of TACE: Unresectable BCLC Stage B HCC

EP: 5.Using Systemic Therapy in BCLC Stage B HCC

EP: 6.REFLECT Trial in BCLC Stage B HCC

EP: 7.Role of TACE in BCLC Stage B HCC

EP: 8.Emerging Combinations of TACE for BCLC Stage B/C HCC

EP: 9.TACE-3 and CheckMate 74W Trials for BCLC stage B or stage C HCC

EP: 10.Frontline Trials for Unresectable HCC

EP: 11.KEYNOTE-240 and HIMALAYA Trials in Advanced HCC

EP: 12.Approaching Second-Line Therapy in HCC

EP: 13.Role of VEGF TKIs for Second-Line Therapy in HCC

EP: 14.CELESTIAL and RESORCE Trials in HCC

EP: 15.Sequencing With Anti-PD-1 Antibodies in HCC

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EP: 16.Using AFP as a Biomarker in HCC

EP: 17.Future Directions of HCC

Stephen L. Chan, MD: Alpha-fetoprotein [AFP] is in the circulations, used as a biomarker because it had been useful in the diagnosis and screening of HCC [hepatocellular carcinoma]. The AFP also had been shown to a prognostic marker. The higher the AFP, the worse the prognosis, and it has also been useful in monitoring the tumor response. In a number of studies it was shown that the drop in trend of the AFP is associated with improvement in the overall survival after the systemic therapy.

We know the AFP may potentially be used as a predictive biomarker, meaning it can be used to predict the response of a certain kind of drug. From the REACH-2 study, we know the ramucirumab, an anti-VEGFR2 antibody, has been shown to improve the overall survival and also the PFS [progression-free survival] of the patient with a baseline AFP higher than the 400 ng/mL. These benefits were not observed in those patients with low AFP group as shown in the REACH study.

This makes the AFP 1 of the biomarkers for predicting a response in HCC. The rationale is not clear yet. We believe the AFP is a surrogate marker or some subclassification, some subgroup of HCC that is particularly more responsive to this VEGFR2 inhibition. But when we check the AFP, apart from monitoring the treatment response, apart from prognosis, 1 of the important tasks is to see whether these patients are more beneficial from the ramucirumab. This will also be applied clinically now and in the future.

Transcript Edited for Clarity