Early alpha‐foetoprotein response associated with treatment efficacy of immune checkpoint inhibitors for advanced hepatocellular carcinoma

医学 肝细胞癌 内科学 危险系数 胃肠病学 置信区间 实体瘤疗效评价标准 肿瘤科 化疗 进行性疾病
作者
Yu‐Yun Shao,Tsung‐Hao Liu,Chiun Hsu,Li-Chun Lü,Yin‐Chung Shen,Zhong‐Zhe Lin,Ann‐Lii Cheng,Chih‐Hung Hsu
出处
期刊:Liver International [Wiley]
卷期号:39 (11): 2184-2189 被引量:72
标识
DOI:10.1111/liv.14210
摘要

Abstract Background Post‐treatment decline in serum alpha‐foetoprotein (AFP) levels has been shown to predict the treatment efficacy of antiangiogenic therapy for advanced hepatocellular carcinoma (HCC). We explored whether a decline in AFP levels was also associated with treatment outcomes of immune checkpoint inhibitors (ICIs) in patients with advanced HCC. Methods We reviewed all patients who received ICI therapy for advanced HCC. AFP response was evaluated in patients with the pretreatment AFP level of >20 ng/mL. We defined early AFP response as a >20% decline in serum AFP levels within the first 4 weeks of treatment initiation relative to pretreatment levels. We then studied whether early AFP response was associated with treatment outcomes. Results Sixty patients were enrolled in this study; 43 of them were evaluable for early AFP response. The objective response rate of early AFP responders was significantly higher than that of early AFP nonresponders (73% vs. 14%, P < .001). Early AFP responders, compared with early AFP nonresponders, exhibited significantly longer overall survival (OS) (median, 28.0 vs 11.2 months, P = .048) and progression‐free survival (PFS) (median, 15.2 vs 2.7 months, P = .002). After adjusting for other clinicopathological variables and treatments, early AFP response remained an independent predictor for longer OS (hazard ratio [HR] = 0.089, 95% confidence interval [CI] = 0.018‐0.441; P = .003) and PFS (HR = 0.128, 95% CI = 0.041‐0.399; P < .001). Conclusion Early AFP response was associated with higher treatment efficacy of ICIs for advanced HCC. Additional validation studies are nonetheless warranted.
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