Evaluation of prognostic scores in patients with HCC undergoing first-line immunotherapy with atezolizumab and bevacizumab

作者：Simon Johannes Gairing, Philipp Mildenberger, Jennifer Gile, Fabian Artusa, Bernhard Scheiner, Catherine Leyh, Sabine Lieb, Friedrich Sinner, Vincent Jörg, Thorben Fruendt, Vera Himmelsbach, Nada Abedin, Cennet Şahin, Katrin Böttcher, Jasmin Schuhbaur, Simon Labuhn, James Korolewicz, Claudia Angela Maria Fulgenzi, Antonio D’Alessio, Valentina Zanuso, Florian Hucke, Natascha Röhlen, Najib Ben Khaled, Eleonora Ramadori, Lukáš Müller, Arndt Weinmann, Roman Kloeckner, Peter R. Galle, Nguyen H. Tran, Sudhakar K. Venkatesh, Andreas Teufel, Matthias P. Ebert, Enrico N. De Toni, Dirk‐Thomas Waldschmidt, Jens U. Marquardt, Dominik Bettinger, Markus Peck‐Radosavljevic, Andreas Geier, Florian P. Reiter, Lorenza Rimassa, David J. Pinato, Christoph Roderburg, Thomas J. Ettrich, Michael Bitzer, Veit Scheble, Ursula Ehmer, Marie‐Luise Berres, Fabian Finkelmeier, Maria A. González-Carmona, Johann von Felden, Kornelius Schulze, Marino Venerito, Florian van Bömmel, Leonie Jochheim, Matthias Pinter, Raphael Mohr, Sumera I. Ilyas, Irene Schmidtmann, Friedrich Foerster · 发表于：JHEP Reports · 年份：2024 · DOI：10.1016/j.jhepr.2024.101295 · 被引用次数：11 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cancer Immunotherapy and Biomarkers、Inflammatory Biomarkers in Disease Prognosis

Background & Aims: Immunotherapy with atezolizumab and bevacizumab (a + b) has improved the prognosis of patients with unresectable hepatocellular carcinoma (HCC). However, the outcome for individual patients is highly variable. This study aimed to (i) develop and validate a prognostic prediction model to estimate individual prognosis and (ii) compare it with established models. Methods: In this multicenter retrospective study, patients with HCC undergoing first-line immunotherapy with a + b from 24 centers (Europe, USA) were included. Statistical analysis and reporting followed the TRIPOD guidelines. The primary objective was overall survival (OS). A Cox model was developed and externally validated. Results: In total, 683 patients were included (training: 526, validation: 157). The C-reactive protein, albumin, bilirubin, lymphocytes, ECOG performance status, and extrahepatic spread (CABLE score) remained significantly associated with OS in Cox regression analysis. In the training set, the CABLE score had a higher discriminatory accuracy relative to ALBI, EZ-ALBI, mALBI, CRAFITY, PNI, NLR, PLR, and GPS (time-dependent AUC 0.79 and C-index 0.75 (95% CI 0.71-0.78) at 12 months). In the external validation set, the discriminatory performance of the CABLE score was comparable to ALBI, EZ-ALBI, and mALBI, but on average higher than PNI, CRAFITY, NLR, PLR, and GPS. In patients with Child-Pugh A, the CABLE score outperformed ALBI, EZ-ALBI, and mALBI in the first 9 months. We provide...