Cancers (Jul 2020)
Immunotherapy in Hepatocellular Cancer Patients with Mild to Severe Liver Dysfunction: Adjunctive Role of the ALBI Grade
- David J. Pinato,
- Takahiro Kaneko,
- Anwaar Saeed,
- Tiziana Pressiani,
- Ahmed Kaseb,
- Yinghong Wang,
- David Szafron,
- Tomi Jun,
- Sirish Dharmapuri,
- Abdul Rafeh Naqash,
- Mahvish Muzaffar,
- Musharraf Navaid,
- Chieh-Ju Lee,
- Anushi Bulumulle,
- Bo Yu,
- Sonal Paul,
- Neil Nimkar,
- Dominik Bettinger,
- Hannah Hildebrand,
- Yehia I. Abugabal,
- Celina Ang,
- Thomas U. Marron,
- Uqba Khan,
- Nicola Personeni,
- Lorenza Rimassa,
- Yi-Hsiang Huang
Affiliations
- David J. Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, London W120HS, UK
- Takahiro Kaneko
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, London W120HS, UK
- Anwaar Saeed
- Department of Medicine, Division of Medical Oncology, Kansas University Cancer Center, Westwood, KS 66160, USA
- Tiziana Pressiani
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy
- Ahmed Kaseb
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Yinghong Wang
- Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- David Szafron
- Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Tomi Jun
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai Hospital, New York, NY 10029, USA
- Sirish Dharmapuri
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai Hospital, New York, NY 10029, USA
- Abdul Rafeh Naqash
- Division of Hematology/Oncology, East Carolina University, 600 Moye Boulevard, Greenville, NC 27834, USA
- Mahvish Muzaffar
- Division of Hematology/Oncology, East Carolina University, 600 Moye Boulevard, Greenville, NC 27834, USA
- Musharraf Navaid
- Division of Hematology/Oncology, East Carolina University, 600 Moye Boulevard, Greenville, NC 27834, USA
- Chieh-Ju Lee
- Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital and Institute of Clinical Medicine, National Yang-Ming University, Taipei 11217, Taiwan
- Anushi Bulumulle
- Division of Hematology/Oncology, East Carolina University, 600 Moye Boulevard, Greenville, NC 27834, USA
- Bo Yu
- Division of Hematology and Oncology, Weill Cornell Medicine/New York Presbyterian Hospital, 1305 York Avenue, Room Y1247, New York, NY 10021, USA
- Sonal Paul
- New York-Presbyterian Brooklyn Methodist Hospital-Weill Cornell Medicine, Brooklyn, NY 11215, USA
- Neil Nimkar
- New York-Presbyterian Brooklyn Methodist Hospital-Weill Cornell Medicine, Brooklyn, NY 11215, USA
- Dominik Bettinger
- Department of Medicine II, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg, 79106 Freiburg, Germany
- Hannah Hildebrand
- Department of Medicine, Division of Medical Oncology, Kansas University Cancer Center, Westwood, KS 66160, USA
- Yehia I. Abugabal
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Celina Ang
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai Hospital, New York, NY 10029, USA
- Thomas U. Marron
- Department of Medicine, Division of Hematology/Oncology, Tisch Cancer Institute, Mount Sinai Hospital, New York, NY 10029, USA
- Uqba Khan
- Division of Hematology and Oncology, Weill Cornell Medicine/New York Presbyterian Hospital, 1305 York Avenue, Room Y1247, New York, NY 10021, USA
- Nicola Personeni
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy
- Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy
- Yi-Hsiang Huang
- Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital and Institute of Clinical Medicine, National Yang-Ming University, Taipei 11217, Taiwan
- DOI
- https://doi.org/10.3390/cancers12071862
- Journal volume & issue
-
Vol. 12,
no. 7
p. 1862
Abstract
Immune checkpoint inhibitors (ICI) have shown positive results in patients with hepatocellular carcinoma (HCC). As liver function contributes to prognosis, its precise assessment is necessary for the safe prescribing and clinical development of ICI in HCC. We tested the accuracy of the albumin-bilirubin (ALBI) grade as an alternative prognostic biomarker to the Child-Turcotte-Pugh (CTP). In a prospectively maintained multi-centre dataset of HCC patients, we assessed safety and efficacy of ICI across varying levels of liver dysfunction described by CTP (A to C) and ALBI grade and evaluated uni- and multi-variable predictors of overall (OS) and post-immunotherapy survival (PIOS). We studied 341 patients treated with programmed-death pathway inhibitors (n = 290, 85%). Pre-treatment ALBI independently predicted for OS, with median OS of 22.5, 9.6, and 4.6 months across grades (p p p > 0.05). ALBI grade identifies a subset of patients with prolonged survival prior to and after ICI therapy, lending itself as an optimal stratifying biomarker to optimise sequencing of systemic therapies in advanced HCC.
Keywords
