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
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2021-11-23
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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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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
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