{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:45:20Z","timestamp":1776923120253,"version":"3.51.2"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>The introduction of immune checkpoint inhibitor (ICI) based therapies has significantly improved the prognosis of patients with unresectable hepatocellular carcinoma (HCC). However, the variable treatment response and the uncertain benefit in patients with advanced liver cirrhosis emphasise the urgent need for prognostic and predictive biomarkers guiding patient selection. The soluble urokinase plasminogen activator receptor (suPAR) is strongly associated with inflammation, liver cirrhosis and various types of cancer. In this study, we investigated suPAR as a potential novel biomarker in patients with unresectable HCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter retrospective study, conducted at three German tertiary care centers, included 90 patients with unresectable HCC and suPAR measurements prior to and during atezolizumab\/bevacizumab therapy. Patients with liver cirrhosis without HCC (<jats:italic>n<\/jats:italic>\u2009=\u2009235) and non\u2010cirrhotic patients with other gastrointestinal tumours (<jats:italic>n<\/jats:italic>\u2009=\u2009155) were selected as control cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median suPAR levels were significantly higher in patients with liver cirrhosis compared to non\u2010cirrhotic cancer patients. A strong association with parameters of liver function, but not with HCC characteristics, was observed. In patients with HCC receiving atezolizumab\/bevacizumab, suPAR was the most accurate independent predictor of hepatic decompensation and overall survival (OS). In addition, suPAR was able to stratify the risk of hepatic decompensation within the different Child\u2010Pugh classes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SuPAR represents a promising novel biomarker in patients with HCC treated with ICI\u2010based therapies and bears the potential to guide the selection of antitumoral systemic therapies in patients with advanced liver cirrhosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.70121","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T12:53:28Z","timestamp":1746190408000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Soluble Urokinase Plasminogen Activator Receptor Predicts Survival and Hepatic Decompensation in Advanced Hepatocellular Carcinoma"],"prefix":"10.1111","volume":"45","author":[{"given":"Fabian","family":"Artusa","sequence":"first","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Lamatsch","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minh Duc","family":"Phan","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burcin","family":"\u00d6zdirik","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilmar","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Egerer","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM)  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Knorr\u2010Klocke","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Charit\u00e9 \u2010 Universit\u00e4tsmedizin 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