Tumor Mutational Burden for Predicting Prognosis and Therapy Outcome of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC), the primary hepatic malignancy, represents the second-highest cause of cancer-related death worldwide. Many efforts have been devoted to finding novel biomarkers for predicting both patients' survival and the outcome of pharmacological treatments, with a particular focus on immunotherapy. In this regard, recent studies have focused on unravelling the role of tumor mutational burden (TMB), i.e., the total number of mutations per coding area of a tumor genome, to ascertain whether it can be considered a reliable biomarker to be used either for the stratification of HCC patients in subgroups with different responsiveness to immunotherapy, or for the prediction of disease progression, particularly in relation to the different HCC etiologies. In this review, we summarize the recent advances on the study of TMB and TMB-related biomarkers in the HCC landscape, focusing on their feasibility as guides for therapy decisions and/or predictors of clinical outcome.

Automated summary

Hepatocellular carcinoma (HCC) is the second-leading cause of cancer-related death globally, and efforts have been made to find novel biomarkers for predicting patients' survival and treatment outcomes, especially in immunotherapy. The role of tumor mutational burden (TMB), the total number of mutations per coding area of a tumor genome, has been studied to determine whether it could be a reliable biomarker for stratifying HCC patients into subgroups with different responsiveness to immunotherapy or predicting disease progression, particularly in relation to different HCC etiologies. This review summarizes the recent advances in studying TMB and TMB-related biomarkers in HCC, focusing on their feasibility as guides for therapy decisions and predictors of clinical outcomes.