| Summary: | Considering the increasing importance of immune checkpoints in tumor immunity we investigated the clinical relevance of serum T-cell immunoglobulin and mucin domain-3 (TIM-3) in patients with hepatocellular carcinoma (HCC). Serum TIM-3 levels were measured and their association with HCC stage and the detection of serum programmed death ligand-1 (PD-L1) were assessed. In patients submitted to transarterial chemoembolization (TACE), pre- and 1-week post-treatment TIM-3 levels were also evaluated. We studied 53 HCC patients with BCLC stages: 0 (5.7%), A (34%), B (32.1%), C (22.6%), and D (5.7%). The patients with advanced HCC (BCLC C) had significantly higher TIM-3 levels than patients with BCLC A (<i>p</i> = 0.009) and BCLC B (<i>p</i> = 0.019). TIM-3 levels were not associated with HCC etiology (<i>p</i> = 0.183). PD-L1 detection (9/53 patients) correlated with TIM-3 levels (univariate analysis, <i>p</i> = 0.047). In 33 patients who underwent TACE, post-treatment TIM-3 levels (231 pg/mL, 132−452) were significantly higher than pre-TACE levels (176 pg/mL, 110−379), (<i>p</i> = 0.036). Complete responders had higher post-TACE TIM-3 levels (534 pg/mL, 370−677) than partial responders (222 pg/mL, 131−368), (<i>p</i> = 0.028). Collectively, TIM-3 may have a role in anti-tumor immunity following TACE, setting a basis for combining immunotherapy and chemoembolization.
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