HIF-1α and VEGF as prognostic biomarkers in hepatocellular carcinoma patients treated with transarterial chemoembolization
Elisa Pinto, Filippo Pelizzaro, Romilda Cardin, Michele Battistel, Giorgio Palano, Federica Bertellini, M.P. Kitenge, Giulia Peserico, Fabio Farinati, Francesco Paolo Russo
Abstract
BackgroundNeoangiogenesis plays a crucial role in the progression of hepatocellular carcinoma (HCC), and concerns have been raised about the role of neoangiogenesis on the effectiveness of transarterial chemoembolization (TACE).AimIn this study, we aimed to evaluate Vascular Endothelial Growth Factor (VEGF) and Hypoxia-Inducible Factor-1α (HIF-1α) as circulating prognostic biomarkers in HCC patients treated with TACE.MethodsBlood samples were collected from 163 patients before (t0) and four weeks after TACE (t1).ResultsHigher levels of VEGF after TACE were demonstrated (264.0 [78.7–450.8] vs. 278.6 [95.0–576.6] pg/mL; p < 0.0001). Responders to TACE had lower levels of VEGF than non-responders both at t0 (200.0 [58.9–415.8] vs. 406.6 [181.4–558.6] pg/mL; p = 0.006) and at t1 (257.3 [68.5–528.6] vs. 425.9 [245.2–808.3] pg/mL; p = 0.003), and in both groups there was an increase in VEGF compared to measurements before treatment (p = 0.001 and p = 0.005, respectively). VEGF was not associated with overall survival (OS), while patients with HIF-1α ≤ 0.49 ng/mL showed better prognosis (median OS 28.0 months [95% CI 19.7–36.3] vs. 17.0 months [95% CI 11.1–22.9]; p = 0.01). Moreover, HIF-1α was identified as an independent prognostic parameter.ConclusionsVEGF and HIF-1α can be considered useful prognostic biomarkers in HCC patients treated with TACE.