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Hepatocellular carcinoma (HCC) causes many deaths worldwide, and current treatments have limitations. Immunotherapies have shown the most promising clinical outcomes for advanced HCC. However, there are many patients with HCC who still respond poorly to these treatments. Circulating biomarkers that can easily be obtained through blood sampling are promising in predicting treatment responses, since they are minimally invasive and enable us to constantly monitor disease progression. The aim of this review is to discuss the most promising types of blood-based biomarkers for the diagnosis and prognosis of HCC, with the focus on circulating tumor cells and circulating tumor DNA. We also discuss technologies for detecting these biomarkers, as well as their clinical applications for immunotherapies in HCC. We conclude that despite their encouraging results to accurately predict responses to immunotherapies, more and larger clinical studies are still necessary, in order to improve the precision of biomarkers, which are used in the treatment decision for patients with HCC.

Hepatocellular carcinoma (HCC) is one of the deadliest cancer types worldwide. HCC is often diagnosed at a late stage when the therapeutic options are very limited. However, even at the earlier stages, the best treatment is liver transplantation, surgical resection or ablation. Surgical resection and ablation may carry a high risk of tumor recurrence. The recent introduction of immunotherapies resulted in clinical responses for a subgroup of patients, but there were still no effective predictive markers for response …