The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study
Sagar, Vandana M Herring, Kathyrn Curbishley, Stuart Hodson, James Fletcher, Peter Karkhanis, Salil Mehrzad, Homoyon Punia, Pankaj Shah, Tahir Shetty, Shishir
Sagar, Vandana M
Herring, Kathyrn
Curbishley, Stuart
Hodson, James
Fletcher, Peter
Karkhanis, Salil
Mehrzad, Homoyon
Punia, Pankaj
Shah, Tahir
Shetty, Shishir
Abstract
Prothrombin induced by vitamin K absence II (PIVKA-II) has recently been validated internationally as a diagnostic biomarker for hepatocellular carcinoma (HCC), as part of the GALAD model. However, its role as a treatment response biomarker has been less well explored. We, therefore, undertook a prospective study at a tertiary centre in the UK to evaluate the role of PIVKA-II as a treatment response biomarker in patients with early, intermediate and advanced stage HCC. In a cohort of 141 patients, we found that PIVKA-II levels tracked concordantly with treatment response in the majority of patients, across a range of different treatment modalities. We also found that rises in PIVKA-II levels almost always predated radiological progression. Among AFP non-secretors, PIVKA-II was found to be informative in 60% of cases. In a small cohort of patients undergoing liver transplantation, pre-transplant PIVKA-II levels predicted for microvascular invasion and poorer differentiation. Our results demonstrate the potential utility of PIVKA-II as a treatment response biomarker and in predicting microvascular invasion, in a Western population. PIVKA-II demonstrated improved performance over AFP but, as a single biomarker, its performance was still limited. Further larger prospective studies are recommended to evaluate PIVKA-II as a treatment response biomarker, within the GALAD model.
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Date
2021-11-23
Type
Article
Subject
Microbiology. Immunology, Gastroenterology, Radiology
Collections
Citation
Sagar VM, Herring K, Curbishley S, Hodson J, Fletcher P, Karkhanis S, Mehrzad H, Punia P, Shah T, Shetty S, Ma YT. The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study. Oncotarget. 2021 Nov 23;12(24):2338-2350. doi: 10.18632/oncotarget.28136
Journal / Source Title
Oncotarget
DOI
10.18632/oncotarget.28136
PMID
34853657
Publisher
Impact Journals
Publisher’s URL
http://www.oncotarget.com/