Liver Cancer Biomarkers
Alpha-fetoprotein (AFP) is the primary blood marker for liver cancer — a simple blood draw that helps confirm diagnosis and track whether treatment is working.
Reviewed by XpertPatient Medical Advisory · Updated June 2026 · Sources: NCI · ACS · ASCO · NIH/PMC
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What is a biomarker?
A biomarker in liver cancer is often a protein released into your blood by cancer cells. The most important one is called AFP — alpha-fetoprotein. When liver cancer is present, AFP levels often rise in your blood, making it detectable with a simple blood test.
Liver cancer often develops in people with underlying liver disease — like cirrhosis or hepatitis. Biomarker testing helps confirm the diagnosis, track treatment, and monitor for recurrence. New systemic treatment options have improved significantly in recent years.
What this means for you: AFP is your main tracking tool. If AFP falls during treatment, it’s usually a sign the treatment is working. If it rises again, your doctor may need to adjust the plan.
The Tests Your Doctor Orders
🔍 Is a protein made by liver cancer cells elevated in your blood?
AFP is the main liver cancer blood marker. Levels above 400 ng/mL in someone with a liver mass strongly suggest hepatocellular carcinoma. About 30% of liver cancers don’t elevate AFP, so imaging is always needed alongside it.
🔍 Is a surface protein present on your cancer cells?
GPC3 is found on liver cancer cells and is being studied as a target for new treatments. Not yet part of standard care, but an active area of research.
🔍 Is a key protective gene damaged?
TP53 mutations are linked to more aggressive liver cancer. Your doctor uses this as one signal to understand how your cancer is likely to behave.
Sources: NCI · American Liver Foundation · ASCO
Watch & Learn
Common Questions
Liver Cancer Biomarkers — Your Questions Answered
What is a normal AFP level?
Below 10 ng/mL in healthy adults. Levels above 400 ng/mL in someone with a liver mass and cirrhosis are highly suspicious for liver cancer — but AFP can also be elevated in other liver conditions, so it’s always interpreted with imaging.
Can AFP be used for screening?
AFP combined with liver ultrasound every 6 months is recommended for high-risk patients — especially those with cirrhosis or chronic hepatitis B or C. This surveillance can catch liver cancer earlier, when it’s more treatable.
What are the main treatment options for liver cancer?
Early-stage: surgery, ablation, or liver transplant. Intermediate stage: embolization (blocking blood supply to the tumor). Advanced stage: immunotherapy combinations like atezolizumab + bevacizumab (Tecentriq + Avastin).
Does PD-L1 matter for liver cancer treatment?
The most common first-line treatment (atezolizumab + bevacizumab) works regardless of PD-L1 level, so PD-L1 is not routinely used to select patients for this regimen.
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