Wang Hung-Wei, Chuang Po-Heng, Su Wen-Pang, Kao Jung-Ta, Hsu Wei-Fan, Lin Chun-Che, Huang Guan-Tarn, Lin Jaw-Town, Lai Hsueh-Chou, Peng Cheng-Yuan
Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan.
School of Medicine, China Medical University, Taichung 404, Taiwan.
Cancers (Basel). 2021 Jul 26;13(15):3758. doi: 10.3390/cancers13153758.
In the RESORCE study, regorafenib after sorafenib therapy improved survival in patients with advanced hepatocellular carcinoma (HCC). In total, 88 patients with unresectable HCC who received sorafenib-regorafenib sequential therapy were enrolled. The objective response rate and disease control rate were 19.3% and 48.9%, respectively, for regorafenib therapy (median duration: 8.1 months). Median progression-free survival (PFS) after regorafenib therapy was 4.2 months (95% CI: 3.2-5.1). The median overall survival (OS; from initiation of either sorafenib or regorafenib) was not reached in this cohort. According to multivariate Cox regression analyses, albumin-bilirubin (ALBI) grade at the initiation of regorafenib therapy is an independent predictor of disease control, PFS, and OS. Moreover, the combination of ALBI grade 2 and an alpha-fetoprotein (AFP) level of ≥20 ng/mL was an independent predictor of PFS (hazard ratio (HR): 3.088, 95% CI: 1.704-5.595; < 0.001) for regorafenib therapy, and OS for both regorafenib (HR: 3.783, 95% CI: 1.316-10.88; = 0.014) and sorafenib-regorafenib sequential (HR: 4.603, 95% CI: 1.386-15.29; = 0.013) therapy. A combination of ALBI grade and AFP level can be used to stratify patients with unresectable HCC by PFS and OS probability for sorafenib-regorafenib sequential therapy.
在RESORCE研究中，索拉非尼治疗后使用瑞戈非尼可改善晚期肝细胞癌（HCC）患者的生存率。共有88例接受索拉非尼-瑞戈非尼序贯治疗的不可切除HCC患者入组。瑞戈非尼治疗的客观缓解率和疾病控制率分别为19.3%和48.9%（中位持续时间：8.1个月）。瑞戈非尼治疗后的中位无进展生存期（PFS）为4.2个月（95%CI：3.2 - 5.1）。该队列的中位总生存期（OS；从索拉非尼或瑞戈非尼开始使用起）未达到。根据多变量Cox回归分析，瑞戈非尼治疗开始时的白蛋白-胆红素（ALBI）分级是疾病控制、PFS和OS的独立预测因素。此外，ALBI 2级与甲胎蛋白（AFP）水平≥20 ng/mL的组合是瑞戈非尼治疗PFS（风险比（HR）：3.088，95%CI：1.704 - 5.595；P < 0.001）以及瑞戈非尼（HR：3.783，95%CI：1.316 - 10.88；P = 0.014）和索拉非尼-瑞戈非尼序贯治疗（HR：4.6I3，95%CI：1.386 - 15.29；P = 0.013）OS的独立预测因素。ALBI分级和AFP水平的组合可用于根据索拉非尼-瑞戈非尼序贯治疗的PFS和OS概率对不可切除HCC患者进行分层。
