Cancer Reports (Apr 2024)

Clinical usefulness of newly developed prognostic predictive score for atezolizumab plus bevacizumab for hepatocellular carcinoma

  • Hideko Ohama,
  • Atsushi Hiraoka,
  • Toshifumi Tada,
  • Masashi Hirooka,
  • Kazuya Kariyama,
  • Takeshi Hatanaka,
  • Joji Tani,
  • Koichi Takaguchi,
  • Masanori Atsukawa,
  • Ei Itobayashi,
  • Takashi Nishimura,
  • Kunihiko Tsuji,
  • Kazuto Tajiri,
  • Toru Ishikawa,
  • Satoshi Yasuda,
  • Hidenori Toyoda,
  • Shinya Fukunishi,
  • Chikara Ogawa,
  • Satoru Kakizaki,
  • Noritomo Shimada,
  • Atsushi Naganuma,
  • Kazuhito Kawata,
  • Hisashi Kosaka,
  • Hidekatsu Kuroda,
  • Tomomitsu Matono,
  • Yutaka Yata,
  • Hironori Ochi,
  • Fujimasa Tada,
  • Kazuhiro Nouso,
  • Asahiro Morishita,
  • Norio Itokawa,
  • Tomomi Okubo,
  • Taeang Arai,
  • Akemi Tsutsui,
  • Takuya Nagano,
  • Keisuke Yokohama,
  • Hiroki Nishikawa,
  • Michitaka Imai,
  • Yohei Koizumi,
  • Shinichiro Nakamura,
  • Hiroko Iijima,
  • Masaki Kaibori,
  • Yoichi Hiasa,
  • Takashi Kumada,
  • Representing the Real‐life Practice Experts for HCC Study Group with Hepatocellular Carcinoma experts from 48 clinics in Japan (RELPEC/HCC 48 Group)

DOI
https://doi.org/10.1002/cnr2.2042
Journal volume & issue
Vol. 7, no. 4
pp. n/a – n/a

Abstract

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Abstract Aims The aim of the present study was to elucidate detailed parameters for prediction of prognosis for patients with unresectable hepatocellular carcinoma (uHCC) receiving atezolizumab plus bevacizumab (Atez/Bev) treatment. Methods A total of 719 patients (males 577, median age 74 years) treated with Atez/Bev between September 2020 and January 2023 were enrolled. Factors related to overall survival (OS) were extracted and a prognostic scoring system based on hazard ratio (HR) was created. OS and progression‐free survival (PFS) were retrospectively examined, and the prognostic ability of the newly developed system was compared to CRAFITY score using concordance index (c‐index) and Akaike information criterion (AIC) results. Results Cox‐hazards multivariate analysis showed BCLC classification C/D (HR 1.4; 1 point), AFP ≥100 ng/mL (HR 1.4; 1 point), mALBI 2a (HR 1.7; 1 point), mALBI 2b/3 (HR 2.8; 2 points), and DCP ≥100 mAU/mL (HR 1.6; 1 point) as significant factors. The assigned points were added and used to develop the IMmunotherapy with AFP, BCLC staging, mALBI, and DCP evaluation (IMABALI‐De) scoring system. For IMABALI‐De scores of 0, 1, 2, 3, 4, and 5, OS was not applicable (NA), NA, 26.11, 18.79, 14.07, and 8.32 months, respectively (p < .001; AIC 2788.67, c‐index 0.699), while for CRAFITY scores of 0, 1, and 2, OS was 26.11, 20.29, and 11.32 months, respectively (p < .001; AIC 2864.54, c‐index 0.606). PFS periods for those IMABALI‐De scores were 21.75, 12.89, 9.18, 8.0, 5.0, and 3.75 months, respectively (p < .001; AIC 5203.32, c‐index 0.623) and for the CRAFITY scores were 10.32, 7.68, and 3.57 months, respectively (p < .001; AIC 5246.61, c‐index 0.574). As compared with CRAFITY score, IMABALI‐De score had better AIC and c‐index results for both OS and PFS. Conclusion The present results indicated that the proposed IMABALI‐De score may be favorable for predicting prognosis of uHCC patients receiving Atez/Bev therapy.

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