Amit Singal, MD: Role of Biomarkers in HCC Risk Stratification, Screening


A discussion on the role of PLSec-AFP for HCC risk stratification in patients with cirrhosis and future screening implementations.

New phase 3 findings validated the use of serum-based 8-protein Prognostic Liver Secretome signature with alpha-fetoprotein (PLSec-AFP) for hepatocellular carcinoma (HCC) risk stratification in patients with cirrhosis.

These findings were presented at the 2022 Digestive Disease Week Annual Meeting in San Diego, California.

In an interview with HCPLive at DDW, Amit Singal, MD, UT Southwestern Medical Center, discussed the need to sufficiently and accurately identify patients who may benefit from more intensive HCC screening versus those who may not warrant screening at all.

The novel biomarker was found highly accurate in defining a higher cohort of patients who develop HCC. Investigators previously looked at at the accuracy in a Phase 2 biomarker study and a pilot phase 3 biomaker study

"We have now validated this in the NCI EDRN Hepatocellular Carcinoma Early Detection Study (HEDS) cohort, a large cohort of patients with cirrhosis who are followed over time and once again show that this has high accuracy for identifying patients who are at higher risk for developing HCC," Singal said.

Singal additionally presented subgroup analyses on a methylated DNA panel for HCC screening. Across multiple subgroups, they reported that the panel appeared to have high accuracy and may be promising for future cohort studies.

He went on to discuss the critical nature of early detection for HCC prognosis and the need for these more accurate tools to identify high risk patients.

"More accurate screening tools such as novel biomarkers, including these methylated DNA panels are essential for us to implement HCC screening, and a highly effective manner to optimize the proportion of patients found at an early stage," Singal said. "And by increasing early stage detection, once again, we can increase curative therapies and we can thereby reduce HCC mortality."

Singal noted his excitement on the cusp of a breakthrough in HCC screening.

"Once we prospectively validate these, I think you will start to see some of these if they have sufficient accuracy, start to be implemented into guidelines and start to be implemented into clinical practice," he said.

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