Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Kamishindenmachi 564-1, Maebashi, Gunma, 371-0821, Japan.
Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.
Hepatol Int. 2022 Oct;16(5):1150-1160. doi: 10.1007/s12072-022-10358-z. Epub 2022 Jun 24.
This study aimed to investigate the utility of C-reactive protein (CRP) and alpha-fetoprotein (AFP) in immunotherapy (CRAFITY) score in hepatocellular carcinoma (HCC) patients receiving atezolizumab and bevacizumab (Atez/Bev).
This retrospective cohort study included a total of 297 patients receiving Atez/Bev from September 2020 to November 2021 at 21 different institutions and hospital groups in Japan. Patients with AFP ≥ 100 ng/mL and those with CRP ≥ 1 mg/dL were assigned a CRAFITY score of 1 point.
The patients were assigned CRAFITY scores of 0 points (n = 147 [49.5%]), 1 point (n = 111 [37.4%]), and 2 points (n = 39 [13.1%]). AFP ≥ 100 ng/mL and CRP ≥ 1.0 mg/dL were significantly associated with progression-free survival (PFS) and overall survival (OS). The median PFS in the CRAFITY score 0, 1, and 2 groups was 11.8 months (95% confidence interval [CI] 6.4-not applicable [NA]), 6.5 months (95% CI 4.6-8.0), and 3.2 months (95% CI 1.9-5.0), respectively (p < 0.001). The median OS in patients with CRAFITY score 0, 1 and 2 was not reached, 14.3 months (95% CI 10.5-NA), and 11.6 months (95% CI 4.9-NA), respectively. The percentage of patients with grade ≥ 3 liver injury, any grade of decreased appetite, any grade of proteinuria, any grade of fever, and any grade of fatigue was lowest in patients with a CRAFITY score of 0, followed by patients with CRAFITY scores of 1 and 2.
The CRAFITY score is simple and could be useful for predicting therapeutic outcomes and treatment-related adverse events.
本研究旨在探讨 C 反应蛋白（CRP）和甲胎蛋白（AFP）在接受阿替利珠单抗和贝伐珠单抗（Atez/Bev）治疗的肝细胞癌（HCC）患者中的免疫治疗（CRAFITY）评分中的效用。
本回顾性队列研究共纳入 297 例 2020 年 9 月至 2021 年 11 月在日本 21 家不同机构和医院组接受 Atez/Bev 治疗的患者。AFP≥100ng/mL 和 CRP≥1mg/dL 的患者被分配 CRAFITY 评分 1 分。
患者的 CRAFITY 评分分别为 0 分（n=147[49.5%]）、1 分（n=111[37.4%]）和 2 分（n=39[13.1%]）。AFP≥100ng/mL 和 CRP≥1.0mg/dL 与无进展生存期（PFS）和总生存期（OS）显著相关。在 CRAFITY 评分 0、1 和 2 组中，中位 PFS 分别为 11.8 个月（95%CI6.4-N/A）、6.5 个月（95%CI4.6-8.0）和 3.2 个月（95%CI1.9-5.0）（p<0.001）。CRAFITY 评分 0、1 和 2 组患者的中位 OS 分别为未达到、14.3 个月（95%CI10.5-N/A）和 11.6 个月（95%CI4.9-N/A）。0 分 CRAFITY 评分患者的肝损伤≥3 级、任何级别食欲下降、任何级别蛋白尿、任何级别发热和任何级别乏力的患者比例最低，其次是 1 分 CRAFITY 评分和 2 分 CRAFITY 评分。
CRAFITY 评分简单，可用于预测治疗效果和治疗相关不良事件。
