Non-invasive method can help predict survival in patients with liver cancer

Hepatocellular carcinoma or HCC is the most commonly observed form of liver cancer and the fourth leading cause of cancer-related death worldwide. For patients with an advanced form of HCC, there are different types of systemic treatments available, which travel through the bloodstream and target cancer cells across the body.

One such treatment involves a combination of the drugs atezolizumab and bevacizumab, and is referred to as Atezo/Bev therapy. Atezo/Bev therapy is generally recommended as the first treatment for patients with liver cancer. However, there are no reliable markers that can be used to predict its effectiveness.

A team of researchers led by Dr. Akinobu Takaki from the Department of Gastroenterology and Hepatology, Okayama University, Japan, along with Dr. Yuki Sasaki, Dr. Kazuyuki Matsumoto, and Dr. Motoyuki Otsuka from Okayama University, Japan have explored the application of anti-PD1 autoantibody for prognosis of cancer. Their findings were published in Gastro Hep Advances on August 2, 2024.

“Although Atezo/Bev combination therapy shows a strong effect, nearly 20% of treated patients show progressive disease. As a result, it is important to predict the efficacy of Atezo/Bev and develop an appropriate regimen,” says Dr. Takaki.

To identify a suitable marker for predicting treatment efficacy, the authors focused on autoantibodies, which are antibodies produced by the immune system that act against an individual’s own proteins. They have been observed in several forms of cancer and can also be easily detected in blood serum, making them good biomarker candidates.

The researchers suspected that an anti-PD-1 autoantibody would affect the outcome of Atezo/Bev therapy, since it targets the same cellular pathways as atezolizumab.

To explore whether anti-PD-1 autoantibody was indeed a good biomarker, they conducted a study with 63 patients with advanced HCC who underwent Atezo/Bev therapy. They also measured anti-PD-1 autoantibody levels in the patients’ blood serum before and after treatment. Subsequently, they investigated if there was any correlation between the autoantibody levels and patient response to treatment.

The results showed a statistically significant correlation between higher anti-PD-1 autoantibody levels and lower survival rates, indicating anti-PD-1 autoantibody is a potential biomarker for a larger class of drugs known as immune checkpoint inhibitors (including atezolizumab) in patients with HCC. However, further studies are needed to shed more light on the biological role of such autoantibodies in cancer immunotherapy.

“Ours is the first study to report that higher serum anti-PD-1 autoantibody levels were associated with a poor prognosis in patients who received Atezo/Bev as first-line therapy. Notably, serum levels of anti-PD-1 autoantibody may serve as a novel potential biomarker for predicting the efficacy of immune checkpoint inhibitors in patients with HCC. Overall, our findings will bring hope to patients with liver cancer and pave the way for development of improved treatment regimens in the future,” concludes Dr. Takaki.