Early Changes in Alpha-Fetoprotein Are a Useful Predictor of Efficacy of Atezolizumab plus Bevacizumab Treatment in Patients with Advanced Hepatocellular Carcinoma
Early Changes in Alpha-Fetoprotein Are a Useful Predictor of Efficacy of Atezolizumab plus Bevacizumab Treatment in Patients with Advanced Hepatocellular Carcinoma
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DOI：
10.1159/000519448
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发表时间：
2021-11-03
期刊：
影响因子：
3.5
通讯作者：
Hirooka, Yoshiki
中科院分区：
文献类型：
--
作者：
Kuzuya, Teiji;Kawabe, Naoto;Hirooka, Yoshiki
前言：本研究的目的是探讨早期甲胎蛋白（AFP）和des-？atzolizumab联合贝伐单抗治疗晚期肝细胞癌（HCC）患者的-羧基凝血酶原（DCP）水平，并评估这些肿瘤标志物的变化与治疗效果之间的关系。方法：在我院连续58例开始使用atezolizumab联合贝伐单抗的患者中，有50例患者在治疗后6周获得抗肿瘤反应信息，并纳入本研究，对其治疗结果进行回顾性评估。结果：根据实体瘤6周反应评价标准，客观缓解率（OR）为22.0%，疾病控制率（DC）为78.0%。在6周达到OR的患者中，第1,2,3和6周的中位AFP和DCP比率显著低于未达到OR的患者。6周未达到DC的患者（非6W-DC组）AFP比值显著高于6周达到DC的患者（6W-DC组）。非6W-DC组的中位总生存期明显短于6W-DC组（156天vs.未达到，p = 0.0008）。3周AFP比值为1.4或更高，预测非6w - dc的特异性为88.0%，敏感性为88.9%。AFP比值为1.4或更高的患者在3周时的中位无进展生存期明显短于AFP比值< 1.4的患者（42天vs 210天，p = 0.0003）。结论：早期AFP变化可能有助于预测晚期HCC患者阿特唑单抗联合贝伐单抗的抗肿瘤疗效。3周AFP比值1.4或更高可能是阿特唑单抗加贝伐单抗治疗难治性的早期预测指标。&,(C) 2021 S. Karger AG，巴塞尔
Introduction: The aim of this study was to investigate the early changes in alpha-fetoprotein (AFP) and des-?-carboxy prothrombin (DCP) levels in patients with advanced hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab and to evaluate the relationship between changes in these tumor markers and treatment efficacy. Methods: Of 58 consecutive patients who started atezolizumab plus bevacizumab at our institution, 50 patients with information on antitumor response obtained at 6 weeks after therapy were enrolled in this study and their treatment outcomes were retrospectively evaluated. Results: According to the Response Evaluation Criteria in Solid Tumors at 6 weeks, the objective response (OR) rate was 22.0% and the disease control (DC) rate was 78.0%. In patients who achieved OR at 6 weeks, median AFP and DCP ratios at weeks 1, 2, 3, and 6 were significantly lower than those in patients who did not achieve OR. AFP ratios in patients who did not achieve DC at 6 weeks (Non-6W-DC group) were significantly higher than in those who achieved DC at week 6 (6W-DC group). Median overall survival in the Non-6W-DC group was significantly shorter than in the 6W-DC group (156 days vs. not reached, p = 0.0008). An AFP ratio of 1.4 or higher at 3 weeks had a specificity of 88.0% and a sensitivity of 88.9% for predicting Non-6W-DC. Median progression-free survival was significantly shorter in patients with an AFP ratio of 1.4 or higher at 3 weeks than in those with an AFP ratio of < 1.4 (42 days vs. 210 days, p = 0.0003). Conclusion: Early changes in AFP might be useful for predicting the antitumor efficacy of atezolizumab plus bevacizumab in patients with advanced HCC. An AFP ratio of 1.4 or higher at 3 weeks might be an early predictor of refractoriness to atezolizumab plus bevacizumab therapy.& nbsp;(C) 2021 S. Karger AG, Basel