Medical Oncology, University and University Hospital of Cagliari, Cagliari, Italy.
Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy;
Anticancer Res. 2023 Apr;43(4):1599-1610. doi: 10.21873/anticanres.16310.
BACKGROUND/AIM: The purpose of this study was to ascertain a novel prognostic index via recursive partitioning analysis (RPA) in hepatocellular carcinoma (HCC) patients being treated with the combination of atezolizumab plus bevacizumab (ABE) in first-line setting.
A total of 784 patients with HCC were included in the analysis.
RPA identified three groups of patients: high-risk [Child-Pugh B (CP-B) patients; CP-A and Albumin-Bilirubin (ALBI)-2 patients; CP-A and ALBI-1 patients with macrovascular invasion (MVI), and alpha-fetoprotein (α-FP) ≥400 ng/ml]; intermediate-risk [CP-A and ALBI-1 patients with aspartate aminotransferase (AST) normal value (NV), and αFP ≥400 ng/ml, but without MVI; CP-A and ALBI-1 patients with AST increased value (IV), and neutrophil-lymphocyte ratio (NLR) ≥3, but without MVI]; low-risk (CP-A and ALBI-1 patients with AST NV, and αFP <400 ng/ml, but without MVI; CP-A and ALBI-1 patients with AST IV, and NLR <3, but without MVI; CP-A and ALBI-1 patients with MVI, and αFP <400 ng/ml). Overall survival was 7.0 months in high-risk patients (20.8%), 14.2 months in intermediate-risk patients (19.1%), and 22.5 months in low-risk patients (60.1%).
The ABE index allows for easy stratification of HCC patients treated with the combination of ABE in first-line setting.
背景/目的：本研究旨在通过递归分割分析（RPA）确定一种新的用于接受阿替利珠单抗联合贝伐珠单抗（ABE）一线治疗的肝细胞癌（HCC）患者的预后指数。
共有 784 例 HCC 患者纳入分析。
RPA 确定了三组患者：高危组[CP-B 患者；CP-A 和 ALBI-2 患者；CP-A 和 ALBI-1 伴大血管侵犯（MVI）且α胎蛋白（AFP）≥400ng/ml]；中危组[CP-A 和 ALBI-1 患者，天门冬氨酸氨基转移酶（AST）正常值（NV）且 AFP≥400ng/ml，但无 MVI；CP-A 和 ALBI-1 患者 AST 升高值（IV）且中性粒细胞与淋巴细胞比值（NLR）≥3，但无 MVI]；低危组[CP-A 和 ALBI-1 患者 AST NV 且 AFP<400ng/ml，但无 MVI；CP-A 和 ALBI-1 患者 AST IV 且 NLR<3，但无 MVI；CP-A 和 ALBI-1 患者伴 MVI，且 AFP<400ng/ml]。高危组患者的总生存期为 7.0 个月（20.8%），中危组为 14.2 个月（19.1%），低危组为 22.5 个月（60.1%）。
ABE 指数可方便地对接受 ABE 一线治疗的 HCC 患者进行分层。
