Kashiv P, Saxena K, Balwani MR, Kute VB. Integrating molecular and immune biomarkers for precision therapy in hepatitis B: Associated hepatocellular carcinoma. World J Hepatol 2026; 18(2): 116475 [DOI: 10.4254/wjh.v18.i2.116475]
Corresponding Author of This Article
Vivek Balkrishna Kute, Professor, Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad 380016, Gujarat, India. drvivekkute@rediffmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Pranjal Kashiv, Department of Nephrology, All India Institute of Medical Sciences, Nagpur 441108, Maharashtra, India
Pranjal Kashiv, Manish Ramesh Balwani, Department of Nephrology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha 442001, Maharashtra, India
Khushboo Saxena, Department of Nephrology, Institute of Kidney Diseases and Research Center, Ahmedabad 380016, Gujarat, India
Manish Ramesh Balwani, Department of Nephrology, Saraswati Kidney Care Center, Nagpur 440015, Maharashtra, India
Vivek Balkrishna Kute, Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad 380016, Gujarat, India
Author contributions: Kashiv P conceptualized the study, designed the methodology, collected data, performed analysis, and drafted the initial manuscript; Saxena K assisted in data collection, literature review, and preparation of figures and tables; Balwani MR provided critical supervision, conceptual guidance, and major revisions of the manuscript; Kute VB contributed to study design, interpretation of results, and final review of the manuscript for important intellectual content; all authors approved the final version and agree to be accountable for all aspects of the work.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vivek Balkrishna Kute, Professor, Department of Nephrology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad 380016, Gujarat, India. drvivekkute@rediffmail.com
Received: November 12, 2025 Revised: December 16, 2025 Accepted: January 5, 2026 Published online: February 27, 2026 Processing time: 92 Days and 18.4 Hours
Abstract
In this editorial, we comment on the article by Wang et al, which investigates molecular and immune biomarkers predictive of response to sintilimab plus lenvatinib in hepatitis B virus-associated hepatocellular carcinoma (HCC). Yet, despite remarkable progress with immune-checkpoint and anti-angiogenic combinations, the biological heterogeneity of HCC continues to limit durable responses and individualized care. By integrating high-resolution transcriptomic, exomic, and immune-cell-profiling data, Wang et al identified a coherent triad - elevated LINC01554 expression, enrichment of CD4+ central-memory T cells, and solitary-tumour morphology - that independently predicted prolonged progression-free survival. This constellation links tumour-intrinsic transcriptional restraint, adaptive immune competence, and anatomical containment, illustrating how multi-omic profiling can clarify determinants of therapeutic benefit. These insights signify a shift from empiricism to biologically guided therapy, providing a scaffold for biologic stratification, longitudinal response monitoring, and rational sequencing of immunotherapeutic and anti-angiogenic agents. Collectively, they redefine HCC as a dynamic biological ecosystem rather than a uniform malignancy and highlight the imperative to embed multi-omic biomarker platforms within future clinical-trial design - marking a decisive step toward precision hepatology in inflammation-driven cancers.
Core Tip: Hepatitis B virus-associated hepatocellular carcinoma exemplifies the complexity of inflammation-driven oncogenesis. The integration of molecular and immune biomarkers enables a more precise prediction of therapeutic response. Emerging multiomic evidence identifies a triad of high LINC01554 expression, increased CD4+ central memory T cells, and solitary tumour morphology that signifies restrained oncogenic signalling, preserved immune competence, and limited clonal heterogeneity. Recognition of this molecular-immune-anatomical interplay provides a biologic framework for patient selection, response monitoring, and rational sequencing of sintilimab and lenvatinib, representing a decisive step toward scientifically grounded precision hepatology in viral hepatocellular carcinoma.
