Cancer Medicine (Mar 2023)
New prognostic system based on inflammation and liver function predicts prognosis in patients with advanced unresectable hepatocellular carcinoma treated with atezolizumab plus bevacizumab: A validation study
- Toshifumi Tada,
- Takashi Kumada,
- Atsushi Hiraoka,
- Kazuya Kariyama,
- Joji Tani,
- Masashi Hirooka,
- Koichi Takaguchi,
- Masanori Atsukawa,
- Shinya Fukunishi,
- Ei Itobayashi,
- Kunihiko Tsuji,
- Kazuto Tajiri,
- Hironori Ochi,
- Toru Ishikawa,
- Satoshi Yasuda,
- Chikara Ogawa,
- Hidenori Toyoda,
- Takeshi Hatanaka,
- Takashi Nishimura,
- Satoru Kakizaki,
- Kazuhito Kawata,
- Noritomo Shimada,
- Fujimasa Tada,
- Kazuhiro Nouso,
- Akemi Tsutsui,
- Hideko Ohama,
- Asahiro Morishita,
- Takuya Nagano,
- Norio Itokawa,
- Tomomi Okubo,
- Taeang Arai,
- Hisashi Kosaka,
- Michitaka Imai,
- Atsushi Naganuma,
- Shinichiro Nakamura,
- Yohei Koizumi,
- Masaki Kaibori,
- Hiroko Iijima,
- Yoichi Hiasa,
- the Real‐life Practice Experts for HCC (RELPEC) Study Group and the Hepatocellular Carcinoma Experts from 48 clinics in Japan (HCC 48) Group
Affiliations
- Toshifumi Tada
- Department of Internal medicine, Division of Gastroenterology and Hepatology Hyogo Medical University Hyogo Japan
- Takashi Kumada
- Department of Nursing Gifu Kyoritsu University Gifu Japan
- Atsushi Hiraoka
- Gastroenterology Center Ehime Prefectural Central Hospital Ehime Japan
- Kazuya Kariyama
- Department of Gastroenterology Okayama City Hospital Okayama Japan
- Joji Tani
- Department of Gastroenterology and Hepatology Kagawa University Kagawa Japan
- Masashi Hirooka
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
- Koichi Takaguchi
- Department of Hepatology Kagawa Prefectural Central Hospital Kagawa Japan
- Masanori Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Shinya Fukunishi
- Department of Gastroenterology Osaka Medical and Pharmaceutical University Osaka Japan
- Ei Itobayashi
- Department of Gastroenterology Asahi General Hospital Chiba Japan
- Kunihiko Tsuji
- Center of Gastroenterology Teine Keijinkai Hospital Hokkaido Japan
- Kazuto Tajiri
- Department of Gastroenterology Toyama University Hospital Toyama Japan
- Hironori Ochi
- Hepato‐biliary Center Japanese Red Cross Matsuyama Hospital Ehime Japan
- Toru Ishikawa
- Department of Gastroenterology Saiseikai Niigata Hospital Niigata Japan
- Satoshi Yasuda
- Department of Gastroenterology and Hepatology Ogaki Municipal Hospital Gifu Japan
- Chikara Ogawa
- Department of Gastroenterology Japanese Red Cross Takamatsu Hospital Kagawa Japan
- Hidenori Toyoda
- Department of Gastroenterology and Hepatology Ogaki Municipal Hospital Gifu Japan
- Takeshi Hatanaka
- Department of Gastroenterology Gunma Saiseikai Maebashi Hospital Gunma Japan
- Takashi Nishimura
- Department of Internal medicine, Division of Gastroenterology and Hepatology Hyogo Medical University Hyogo Japan
- Satoru Kakizaki
- Department of Clinical Research National Hospital Organization Takasaki General Medical Center Gunma Japan
- Kazuhito Kawata
- Department of Hepatology Hamamatsu University School of Medicine Shizuoka Japan
- Noritomo Shimada
- Division of Gastroenterology and Hepatology Otakanomori Hospital Chiba Japan
- Fujimasa Tada
- Gastroenterology Center Ehime Prefectural Central Hospital Ehime Japan
- Kazuhiro Nouso
- Department of Gastroenterology Okayama City Hospital Okayama Japan
- Akemi Tsutsui
- Department of Hepatology Kagawa Prefectural Central Hospital Kagawa Japan
- Hideko Ohama
- Gastroenterology Center Ehime Prefectural Central Hospital Ehime Japan
- Asahiro Morishita
- Department of Gastroenterology and Hepatology Kagawa University Kagawa Japan
- Takuya Nagano
- Department of Hepatology Kagawa Prefectural Central Hospital Kagawa Japan
- Norio Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Tomomi Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Taeang Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Nippon Medical School Tokyo Japan
- Hisashi Kosaka
- Department of Surgery Kansai Medical University Osaka Japan
- Michitaka Imai
- Department of Gastroenterology Saiseikai Niigata Hospital Niigata Japan
- Atsushi Naganuma
- Department of Gastroenterology National Hospital Organization Takasaki General Medical Center Gunma Japan
- Shinichiro Nakamura
- Department of Internal Medicine Japanese Red Cross Himeji Hospital Hygo Japan
- Yohei Koizumi
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
- Masaki Kaibori
- Department of Surgery Kansai Medical University Osaka Japan
- Hiroko Iijima
- Department of Internal medicine, Division of Gastroenterology and Hepatology Hyogo Medical University Hyogo Japan
- Yoichi Hiasa
- Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Ehime Japan
- the Real‐life Practice Experts for HCC (RELPEC) Study Group and the Hepatocellular Carcinoma Experts from 48 clinics in Japan (HCC 48) Group
- DOI
- https://doi.org/10.1002/cam4.5495
- Journal volume & issue
-
Vol. 12,
no. 6
pp. 6980 – 6993
Abstract
Abstract Aim Recently, the neo‐Glasgow prognostic score (GPS), a composite biomarker determined by the C‐reactive protein level and albumin–bilirubin grade, was developed to predict outcomes in hepatocellular carcinoma (HCC) patients who undergo hepatic resection. The present research investigated whether the neo‐GPS could predict prognosis in HCC patients treated with atezolizumab plus bevacizumab (Atez/Bev). Methods A total of 421 patients with HCC who were treated with Atez/Bev were investigated. Results Multivariate Cox hazards analysis showed that a GPS of 1 (hazard ratio (HR), 1.711; 95% confidence interval (CI), 1.106–2.646) and a GPS of 2 (HR, 4.643; 95% CI, 2.778–7.762) were independently associated with overall survival. Conversely, multivariate Cox hazards analysis showed that a neo‐GPS of 1 (HR, 3.038; 95% CI, 1.715–5.383) and a neo‐GPS of 2 (HR, 5.312; 95% CI, 2.853–9.890) were also independently associated with overall survival in this cohort. Additionally, cumulative overall survival rates differed significantly by GPS and neo‐GPS (p < 0.001). The neo‐GPS, compared with the GPS, had a lower Akaike information criterion (1207 vs. 1,211, respectively) and a higher c‐index (0.677 vs. 0.652, respectively) regarding to overall survival. In a subgroup analysis of patients considered to have a good prognosis as confirmed using a Child–Pugh score of 5 (p = 0.001), a neutrophil‐to‐lymphocyte ratio <3 (p = 0.001), or an α‐fetoprotein level < 100 ng/mL (p < 0.001), those with a high neo‐GPS (≥1) had a statistically poorer overall survival than those with a low neo‐GPS. Conclusions The neo‐GPS can predict prognosis in advanced unresectable HCC patients treated with Atez/Bev.
Keywords
- atezolizumab plus bevacizumab
- Glasgow prognostic score
- hepatocellular carcinoma
- neo‐Glasgow prognostic score
- survival
