Early Decrease in α-Fetoprotein, but Not Des-γ-Carboxy Prothrombin, Predicts Sorafenib Efficacy in Patients with Advanced Hepatocellular Carcinoma
Early Decrease in α-Fetoprotein, but Not Des-γ-Carboxy Prothrombin, Predicts Sorafenib Efficacy in Patients with Advanced Hepatocellular Carcinoma
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DOI：
10.1159/000334454
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发表时间：
2011-01-01
期刊：
影响因子：
3.5
通讯作者：
Izumi, Namiki
中科院分区：
文献类型：
--
作者：
Kuzuya, Teiji;Asahina, Yasuhiro;Izumi, Namiki
目的：本研究的目的是探讨晚期肝细胞癌（HCC）患者服用索拉非尼后早期肿瘤标志物甲胎蛋白（AFP）和脱羧基凝血酶原（DCP）的早期变化与索拉非尼早期抗肿瘤反应之间的关系。方法：对 48 名晚期 HCC 患者进行了评估。在基线、2周和4周后测量AFP和DCP，并在开始索拉非尼治疗4周后根据RECIST标准评估抗肿瘤反应。通过将患者分层为部分缓解（PR）+疾病稳定（SD）组或疾病进展（PD）组来比较每种肿瘤标志物的比率。结果：开始索拉非尼治疗后 2 周和 4 周，PR + SD 组 (n = 32) 的 AFP 比值均显着低于 PD 组 (n = 16；p = 0.002，p = 0.002)。开始索拉非尼治疗后 2 周和 4 周，PR + SD 组和 PD 组的 DCP 均升高。结论：开始索拉非尼治疗后 2 周和 4 周评估 AFP 比率可能有助于预测抗肿瘤反应。另一方面，DCP 早期升高并不一定表明索拉非尼治疗失败，因为尽管有治疗效果，但 DCP 仍可能升高。版权所有 (C) 2011 S. Karger AG，巴塞尔
Objectives: The aim of this study was to investigate the relationships between early changes in the tumor markers alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP), and antitumor response in the early period following administration of sorafenib in patients with advanced hepatocellular carcinoma (HCC). Methods: Forty-eight advanced HCC patients were evaluated. AFP and DCP were measured at baseline, and after 2 and 4 weeks, and the antitumor responses were evaluated according to the RECIST criteria 4 weeks after starting sorafenib therapy. The ratios of each tumor marker were compared by stratifying the patients into the partial response (PR) + stable disease (SD) group or the progressive disease (PD) group. Results: Both 2 and 4 weeks after starting sorafenib therapy, the AFP ratio in the PR + SD group (n = 32) was significantly lower than in the PD group (n = 16; p = 0.002, p = 0.002). DCP was elevated in both the PR + SD group and the PD group 2 weeks and 4 weeks after starting sorafenib therapy. Conclusions: Evaluation of AFP ratios 2 and 4 weeks after starting sorafenib therapy may be useful for predicting antitumor response. On the other hand, early elevation of DCP does not necessarily suggest treatment failure by sorafenib, as DCP elevation can occur despite therapeutic efficacy. Copyright (C) 2011 S. Karger AG, Basel