Prognostic and predictive factors for locoregional and systemic therapies in hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a growing health concern, with an estimated global incidence of over 1 million by 2025. In its intermediate and advanced stages, HCC remains a challenging condition to treat, despite a recently expanded array of systemic therapies, which continues to grow. Extensive efforts have accordingly been made to identify predictive factors to guide treatment decisions. However, currently, only one predictive biomarker is in widespread clinical use, namely elevated alpha-fetoprotein for second-line systemic therapy with ramucirumab. This article reviews known prognostic and predictive biomarkers for patients with HCC who are treated with locoregional and systemic therapies, including recent controversies around the potential impact of HCC aetiology on the efficacy of systemic therapies.