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At present, the diagnostic accuracy of alpha-fetoprotein (AFP) for hepatocellular carcinoma (HCC) surveillance is insufficient. It remains controversial whether prothrombin induced by vitamin K absence II (PIVKA-II) has a better diagnostic value than AFP for HCC patients.This study aims to investigate the diagnostic role of PIVKA-II alone or in combination with AFP in Chinese HCC patients.

 

Serum AFP and PIVKA-II levels were detected and analyzed in 308 HCC afflicted patients and 120 unafflicted controls. The receiver operator curve (ROC) and area under the curve (AUC) were conducted to evaluate the clinical value of AFP and PIVKA-II for diagnosing HCC and early HCC.

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The aim of this study was to investigate the efficacy of combined detection of 5 serological tumor markers including macrophage migration inhibitory factor (MIF) and abnormal prothrombin (PIVKA-II) in the early diagnosis of primary liver cancer.

 

A total of 90 patients with suspected primary liver cancer admitted from January 2016 to May 2017 were selected as the research subjects. All patients were examined by imaging and histopathology. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum MIF, GP73 and PIVKA-II. Automatic electrochemiluminescence immunoassay system was used to detect serum AFP and AFP-L3. The diagnostic value of single and combined detection of five serological tumor markers for primary liver cancer was compared and analyzed.

Recommendations to ensure NGS standardisation & quality, based on roundtable discussions with experts in oncololgy, pathology, policy makers, and industry experts

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The advancement of technology has created more opportunities for Next-Generation Sequencing (NGS). With greater public interest in Precision Medicine, it seems hopeful that NGS can potentially change the paradigm in oncology diagnostics and treatment decision-making.

To realise the potential of NGS, different stakeholders should work together to establish more effective and market-appropriate national policy strategies. These strategies should focus on reinforcing the value of quality NGS as well as ensuring the need for quality assurance and standardisation.

In this paper, the authors share their recommendations on ensuring standardisation and quality NGS across the region.

National Comprehensive Cancer Network NSCLC and SCLC guideline recommendations for cancer care decision-making

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The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) document evidence-based, consensus-driven management to ensure that all patients receive preventive, diagnostic, treatment, and supportive services that are most likely to lead to optimal outcomes.

The NCCN Guidelines are a comprehensive set of guidelines detailing the sequential management decisions and interventions to assist in the decision-making process of individuals involved in cancer care (including physicians, nurses, pharmacists, payers, patients and their families), with the ultimate goal of improving patient care and outcomes.

The NCCN Guidelines provide recommendations based on the best evidence available at the time they are derived, and are continuously updated and revised to reflect new data and clinical information that may add to or alter current clinical practice standards.

Read the latest NCCN lung cancer guidelines below:

Meta-analysis to evaluate the performance & diagnostic value of AFP and PIVKA-II across different HCC risk factors

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This meta-analysis aimed to clarify the diagnostic value of these two serum markers in patients with different risk of HCC development, such as etiology, ethnicity, and various stages of tumor. The impact of varying study types of literature and detection methods of index test on the diagnosis outcome was also explored, providing evidence for the two serum markers in the clinical management of patients at risk of tumor development.

The authors found that overall, the diagnostic accuracy of DCP (PIVKA-II) was superior to AFP. However, the diagnostic performance of AFP and DCP (PIVKA-II) was different in different ethnicity, etiology, and detection methods. The authors concluded that the combination of DCP (PIVKA-II) and AFP can improve the effectiveness of surveillance for patients at risk of HCC.

Meta-analysis of biomarkers for HCC diagnosis, including AFP, DCP (PIVKA-II), GPC3, GP73, Hsp90alpha, midkine, and OPN

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Hepatocellular carcinoma lacks ideal diagnostic biomarkers. There is a lack of scientific evaluation of relevant promising biomarkers as well. Therefore this study reanalyzes the related studies of 11 blood biomarkers of HCC, and compares the diagnostic value of these biomarkers for HCC systematically.

The authors found that the combination of AFP and other biomarkers improved the diagnostic efficiency. The diagnostic value of biomarkers including DCP (PIVKA-II), GPC3, GP73, Hsp90alpha, midkine, and OPN was higher than that of AFP. GP73 had the best diagnostic value for HCC.

Performance review of Phase II liver cancer tumor markers & biomarker panels for the early detection of HCC

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Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide, and the cancer with the fastest increase in mortality in the United States, with more than 39,000 cases and 29,000 deaths in 2018. As with many cancers, survival is significantly improved by early detection. The median survival of patients with early HCC is >60 months but <15 months when detected at an advanced stage. Surveillance of at-risk patients improves outcome, but fewer than 20% of those at risk for HCC receive surveillance, and current surveillance strategies have limited sensitivity and specificity.

Ideally, blood-based biomarkers with adequate sensitivity or specificity would be available for early detection of HCC; however, the most commonly used biomarker for HCC, alpha-fetoprotein (AFP), has inadequate performance characteristics. There are several candidate serum proteomic, glycomic, and genetic markers that have gone through early stages of biomarker validation and have shown promise for the early detection of HCC, but these markers require validation in well-curated cohorts. Ongoing prospective cohort studies will permit retrospective longitudinal (phase III biomarker study) validation of biomarkers. In this review, the authors highlight promising candidate biomarkers and biomarker panels that have completed phase II evaluation but require further validation prior to clinical use.