ArticleBMC cancer2025
PIVKA-II as a surrogate biomarker for therapeutic response in Non-AFP-secreting hepatocellular carcinoma.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Stereotactic body radiation therapy combined with cadonilimab and lenvatinib in the treatment of hepatocellular carcinoma with Vp3 or Vp4 portal vein tumor thrombus: a prospective, multicenter, single-arm, phase II clinical trial.Frontiers in immunology · 2025Trial
- Multimodal clinical parameters-based immune status associated with the prognosis in patients with hepatocellular carcinoma.World journal of gastrointestinal oncology · 2026Review
- Protein Induced by Vitamin K Absence or Antagonist II in Primary Liver Cancer: Basic Research Insights and Clinical Applications.Journal of clinical and translational hepatology · 2025Review
- Protein induced by vitamin K absence or antagonist II as a prognostic marker in hepatocellular carcinoma patients with normal serum alpha-fetoprotein levels.Journal of the Chinese Medical Association : JCMA · 2025Article
- Dual tissue mRNA and serum protein signatures improve risk stratification in hepatocellular carcinoma.NPJ precision oncology · 2025Article
- Article
- Early PIVKA-II Response Predicts Treatment Efficacy of Immune Checkpoint Inhibitors in Patients with Advanced Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2025Article
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8 authors.
Funding
Abstract
backgroundAlpha-fetoprotein (AFP) is a key biomarker for hepatocellular carcinoma (HCC), but 30-40% of cases are AFP-negative. Prothrombin induced by vitamin K absence II (PIVKA-II) is more sensitive for HCC detection, though its role in systemic therapy remains underexplored. This study aimed to evaluate PIVKA-II in non-AFP-secreting HCC treated with systemic therapy.
methodsPatients with unresectable HCC undergoing systemic therapy were enrolled. Baseline imaging and PIVKA-II levels were recorded. After 8-12 weeks of treatment, response was evaluated through imaging and repeat PIVKA-II measurements.
resultsA total of 116 treatment assessments from 61 cases were analyzed. Baseline PIVKA-II levels correlated with tumor size, but not tumor number or liver function. PIVKA-II regression (≥ 50% reduction) and progression (≥ 50% increase) were defined using ROC analysis. Imaging showed 71.0% objective response in the regression group, 50.0% stable disease in the stable group, and 83.7% progressive disease in the progression group (p < 0.001). This association held for targeted therapies, immune checkpoint inhibitors, and chemotherapy. Progression-free survival (PFS) for the regression, stable, and progression groups was non-reached, 6.7, and 3.2 months (p = 0.0002), and overall survival (OS) was non-reached, non-reached, and 18.5 months (p = 0.02).
conclusionsThis study is the first to establish the "50-50 rule" for PIVKA-II response in non-AFP-secreting HCC treated with systemic therapy, highlighting its value as a surrogate marker for radiological outcomes and prognosis.
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