The following is a summary of “Alpha-fetoprotein combined with initial tumor shape irregularity in predicting the survival of patients with advanced hepatocellular carcinoma treated with immune-checkpoint inhibitors: a retrospective multi-center cohort study,” published in the December 2024 issue of Gastroenterology by Zhang et al.
Immune checkpoint inhibitors (ICIs) are increasingly used to treat hepatocellular carcinoma (HCC).
Researchers conducted a retrospective study exploring the prognostic value of alpha-fetoprotein (AFP) and tumor shape irregularity in people with HCC receiving ICIs.
They involved 296 people with HCC and were assigned to training and validation sets in a 3:2 ratio. The training set identified crucial prognostic factors and established a simple-to-use ATSI (AFP and Tumor Shape Irregularity) score, confirmed in the validation set.
The results showed that the ATSI score was derived from 2 independent risk factors, baseline AFP ≥400 ng/ml (HR 1.73, 95% CI 1.01–2.96, P=0.046) and initial tumor shape irregularity (HR 1.94, 95% CI 1.03–3.65, P=0.041). The median OS was not reached (95% CI 28.20–NA) for people who met no criteria (0 points), 25.8 months (95% CI 14.17–NA) for those who met 1 criterion (1 point), and 17.03 months (95% CI 11.73–23.83) for those who met both criteria (2 points) (P=0.001). The median progression-free survival (PFS) was 10.83 months (95% CI 9.27–14.33) for 0 points, 8.03 months (95% CI 6.77–10.57) for 1 point, and 5.03 months (95% CI 3.83–9.67) for 2 points (P<0.001). Results from the validation set confirmed these findings, with median OS of 37.43/24.27/14.03 months for 0/1/2 points (P=0.028) and median PFS of 13.93/8.30/4.90 months for 0/1/2 points (P<0.001).
They concluded that the ATSI score can effectively predict survival in people with HCC who were treated with ICIs.
Source: link.springer.com/article/10.1007/s00535-024-02202-y
