P9 Biomarker Panel to Predict Hepatocellular Cancer Risk in Cirrhosis Patients

A recent study published in the BMJ Gut unveiled a novel biomarker panel that could revolutionize the prediction of hepatocellular cancer (HCC) risk in patients with cirrhosis. This research was conducted as a part of a longitudinal phase III study explores the intricate relationship between inflammatory and metabolic biomarkers and the onset of HCC.

This study led by a team of Hashem El-Serag utilized data from a prospective cohort of 2266 adult patients with cirrhosis, who were meticulously monitored until the emergence of HCC. Through a meticulous process, the study custom-designed a FirePlex immunoassay to gauge baseline serum levels of 39 biomarkers by ultimately identifying a set of nine biomarkers with the highest discriminatory ability for HCC.

These nine biomarkers was collectively termed as P9 included insulin growth factor-1, interleukin-10, transforming growth factor β1, adipsin, fetuin-A, interleukin-1 β, macrophage stimulating protein α chain, serum amyloid A, and TNF-α. When integrated into existing clinical models, P9 expressed a promising predictive performance.

The addition of P9 to established clinical models, like the AFP (alpha-fetoprotein) model and aMAP score resulted in substantial improvements in the prediction of HCC risk. When combined with the AFP model, the incorporation of P9 boosted the area under the receiver operating characteristic curve (AUROC) by 4.8% and 2.7% at 1 and 2 years, respectively. Also, when added to the aMAP score, P9 enhanced AUROC by 14.2% and 7.6% at 1 and 2 years, respectively. The potential to refine risk stratification models for HCC offers clinicians a more precise tool to identify patients who are at heightened risk.

Reference:

El-Serag, H., Kanwal, F., Ning, J., Powell, H., Khaderi, S., Singal, A. G., Asrani, S., Marrero, J. A., Amos, C. I., Thrift, A. P., Luster, M., Alsarraj, A., Olivares, L., Skapura, D., Deng, J., Salem, E., Najjar, O., Yu, X., Duong, H., … Kaochar, S. (2024). Serum biomarker signature is predictive of the risk of hepatocellular cancer in patients with cirrhosis. In Gut (p. gutjnl-2024-332034). BMJ. https://doi.org/10.1136/gutjnl-2024-332034