Predictors of response and survival in patients with unresectable hepatocellular carcinoma treated with nivolumab: real-world experience.

医学 无容量 内科学 肝细胞癌 危险系数 优势比 胃肠病学 队列 不利影响 回顾性队列研究 肝癌 癌症 肿瘤科 置信区间 免疫疗法
作者
Wei‐Fan Hsu,Chiun Hsu,Cheng‐Kuo Chen,Hung‐Wei Wang,Mu‐Hung Tsai,Wen‐Pang Su,Hung‐Yao Chen,Chi‐Ying Yang,Chun‐Che Lin,Guan‐Tarn Huang,Jaw‐Town Lin,Hsueh‐Chou Lai,Cheng‐Yuan Peng
出处
期刊:American Journal of Cancer Research 卷期号:10 (12): 4547-4560 被引量:15
标识
摘要

Real-world predictors of the treatment efficacy of immune checkpoint inhibitors for hepatocellular carcinoma (HCC) are unknown. This retrospective study enrolled 87 consecutive patients with unresectable HCC from May 2017 to December 2019 at two hospitals. Of the 87 patients, 7, 9, 60, and 11 patients had Barcelona Clinic Liver Cancer stages A, B, C, and D, respectively, and 45, 30, and 10 patients were Child-Pugh class A, B, and C, respectively. The median injection numbers of nivolumab and treatment duration were 6 (3-8) and 2.53 (1.47-4.23) months, respectively, and 64.4% of patients received combination therapy. Radiological imaging was not assessed for 25 patients. Objective response (OR) and disease control rates were 19.5% and 39.1%, respectively. A single tumor (odds ratio: 9.542, P = .015) and ≥20% decline in serum α-fetoprotein protein (AFP) levels within the first 3 months of treatment (defined as AFP response, odds ratio: 5.997, P = .042) were predictors of OR. Lack of macrovascular invasion, combination therapy, and AFP response were predictors of progression-free survival. A Cancer of the Liver Italian Program (CLIP) score of 0-2 (hazard ratio [HR]: 3.717, P = .004) and grade 1-2 immune-related adverse events (irAEs, HR: 2.217, P = .049) were predictors of overall survival (OS) in the entire cohort, and a CLIP score of 0-2 (HR: 3.257, P = .009) was a predictor of OS in evaluable patients. IrAEs ≥ grade 3 were noted in 14 patients, and three died as a result. Having a single tumor and AFP response were predictors of OR, and CLIP score was a predictor of OS.

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