Prognostic Significance of C-Reactive Protein in Unresectable Hepatocellular Carcinoma treated with Atezolizumab and Bevacizumab.
C-reactive protein
alpha fetoprotein
atezolizumab plus bevacizumab
hepatocellular carcinoma
Journal
Hepatology research : the official journal of the Japan Society of Hepatology
ISSN: 1386-6346
Titre abrégé: Hepatol Res
Pays: Netherlands
ID NLM: 9711801
Informations de publication
Date de publication:
22 Dec 2023
22 Dec 2023
Historique:
revised:
26
11
2023
received:
26
09
2023
accepted:
11
12
2023
medline:
22
12
2023
pubmed:
22
12
2023
entrez:
22
12
2023
Statut:
aheadofprint
Résumé
C-reactive protein (CRP) is both an inflammatory and prognostic marker in various cancers. This study aimed to elucidate the characteristics of CRP and the prognostic factors in patients who were administered with atezolizumab plus bevacizumab (ATZ + BEV) for unresectable hepatocellular carcinoma (HCC). A total of 213 patients who received ATZ + BEV for HCC from November 2020 to March 2023 at 15 hospitals were enrolled in this retrospective study. The prognosis was analyzed by subdividing the patients based on baseline characteristics, radiologic response, and treatment lines. Accuracy of survival prediction was assessed using CRP, alpha fetoprotein (AFP), CRP and AFP in immunotherapy (CRAFITY), and Glasgow Prognostic score (GPS). Compared with patients with baseline CRP <1 mg/dL, those with baseline CRP ≥1 mg/dL (n = 45) had significantly higher baseline albumin-bilirubin (ALBI) score and AFP levels, significantly lower disease control rate (62.2%), and significantly shorter median overall survival (HR 2.292; 95% CI 1.313-5.107; log rank test, P <0.001). Multivariate analysis identified CRP ≥1 mg/dL, AFP ≥100 ng/mL, and modified ALBI grade as the significant prognostic factors. The baseline CRP, AFP, CRAFITY, and GPS demonstrated higher discrimination for one-year survival prediction after first line ATZ + BEV administration, compared with beyond second line, with AUROCs of 0.759, 0.761, 0.805, and 0.717, respectively. CRP was a significant biomarker in patients treated with ATZ + BEV for HCC. Elevated CRP levels may indicate aggressive cancer progression and potential resistance to ATZ + BEV therapy. This article is protected by copyright. All rights reserved.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
C-reactive protein (CRP) is both an inflammatory and prognostic marker in various cancers. This study aimed to elucidate the characteristics of CRP and the prognostic factors in patients who were administered with atezolizumab plus bevacizumab (ATZ + BEV) for unresectable hepatocellular carcinoma (HCC).
METHODS
METHODS
A total of 213 patients who received ATZ + BEV for HCC from November 2020 to March 2023 at 15 hospitals were enrolled in this retrospective study. The prognosis was analyzed by subdividing the patients based on baseline characteristics, radiologic response, and treatment lines. Accuracy of survival prediction was assessed using CRP, alpha fetoprotein (AFP), CRP and AFP in immunotherapy (CRAFITY), and Glasgow Prognostic score (GPS).
RESULTS
RESULTS
Compared with patients with baseline CRP <1 mg/dL, those with baseline CRP ≥1 mg/dL (n = 45) had significantly higher baseline albumin-bilirubin (ALBI) score and AFP levels, significantly lower disease control rate (62.2%), and significantly shorter median overall survival (HR 2.292; 95% CI 1.313-5.107; log rank test, P <0.001). Multivariate analysis identified CRP ≥1 mg/dL, AFP ≥100 ng/mL, and modified ALBI grade as the significant prognostic factors. The baseline CRP, AFP, CRAFITY, and GPS demonstrated higher discrimination for one-year survival prediction after first line ATZ + BEV administration, compared with beyond second line, with AUROCs of 0.759, 0.761, 0.805, and 0.717, respectively.
CONCLUSIONS
CONCLUSIONS
CRP was a significant biomarker in patients treated with ATZ + BEV for HCC. Elevated CRP levels may indicate aggressive cancer progression and potential resistance to ATZ + BEV therapy. This article is protected by copyright. All rights reserved.
Types de publication
Journal Article
Langues
eng
Informations de copyright
This article is protected by copyright. All rights reserved.