Published online Sep 18, 2015. doi: 10.4254/wjh.v7.i20.2245
Peer-review started: December 10, 2014
First decision: February 7, 2015
Revised: May 16, 2015
Accepted: August 30, 2015
Article in press: August 31, 2015
Published online: September 18, 2015
Processing time: 279 Days and 5.2 Hours
Many years after therapeutic wilderness, sorafenib finally showed a clinical benefit in patients with advanced hepatocellular carcinoma. After the primary general enthusiasm worldwide, some disappointments emerged particularly since no new treatment could exceed or at least match sorafenib in this setting. Without these new drugs, research focused on optimizing care of patients treated with sorafenib. One challenging research approach deals with identifying prognostic and predictive biomarkers of sorafenib in this population. The task still seems difficult; however appropriate investigations could resolve this dilemma, as observed for some malignancies where other drugs were used.
Core tip: The approval of sorafenib in advanced hepatocellular carcinoma is based on the positive results of two large randomized phase III clinical trials. The inter- and intra-individual variability regarding tumor response and clinical outcome highlighted the unmet need of effective biomarkers of response. These biomarkers could be useful for monitoring treatment activity, detecting early resistance to treatment and identifying patients who would more likely benefit from treatment. An overview of prognostic/predictive biomarkers of sorafenib in hepatocellular carcinoma is discussed in this review.