Prognostic impact of C-reactive protein and alpha-fetoprotein in immunotherapy score in hepatocellular carcinoma patients treated with atezolizumab plus bevacizumab: a multicenter retrospective study

医学 内科学 阿替唑单抗 贝伐单抗 胃肠病学 肝细胞癌 置信区间 回顾性队列研究 外科 免疫疗法 癌症 无容量 化疗
作者
Takeshi Hatanaka,Satoru Kakizaki,Atsushi Hiraoka,Toshifumi Tada,Masashi Hirooka,Kazuya Kariyama,Joji Tani,Masanori Atsukawa,Koichi Takaguchi,Ei Itobayashi,Shinya Fukunishi,Kunihiko Tsuji,Toru Ishikawa,Kazuto Tajiri,Hironori Ochi,Satoshi Yasuda,Hidenori Toyoda,Chikara Ogawa,Takashi Nishimura,Noritomo Shimada
出处
期刊:Hepatology International [Springer Science+Business Media]
卷期号:16 (5): 1150-1160 被引量:64
标识
DOI:10.1007/s12072-022-10358-z
摘要

This study aimed to investigate the utility of C-reactive protein (CRP) and alpha-fetoprotein (AFP) in immunotherapy (CRAFITY) score in hepatocellular carcinoma (HCC) patients receiving atezolizumab and bevacizumab (Atez/Bev). This retrospective cohort study included a total of 297 patients receiving Atez/Bev from September 2020 to November 2021 at 21 different institutions and hospital groups in Japan. Patients with AFP ≥ 100 ng/mL and those with CRP ≥ 1 mg/dL were assigned a CRAFITY score of 1 point. The patients were assigned CRAFITY scores of 0 points (n = 147 [49.5%]), 1 point (n = 111 [37.4%]), and 2 points (n = 39 [13.1%]). AFP ≥ 100 ng/mL and CRP ≥ 1.0 mg/dL were significantly associated with progression-free survival (PFS) and overall survival (OS). The median PFS in the CRAFITY score 0, 1, and 2 groups was 11.8 months (95% confidence interval [CI] 6.4-not applicable [NA]), 6.5 months (95% CI 4.6–8.0), and 3.2 months (95% CI 1.9–5.0), respectively (p < 0.001). The median OS in patients with CRAFITY score 0, 1 and 2 was not reached, 14.3 months (95% CI 10.5-NA), and 11.6 months (95% CI 4.9-NA), respectively. The percentage of patients with grade ≥ 3 liver injury, any grade of decreased appetite, any grade of proteinuria, any grade of fever, and any grade of fatigue was lowest in patients with a CRAFITY score of 0, followed by patients with CRAFITY scores of 1 and 2. The CRAFITY score is simple and could be useful for predicting therapeutic outcomes and treatment-related adverse events.
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