Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Radiotherapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Immunol. 2023 Jul 27;14:1229560. doi: 10.3389/fimmu.2023.1229560. eCollection 2023.
There is no study focusing on noninvasive predictors for the efficacy of sintilimab (anti-PD-1) plus IBI305 (a bevacizumab biosimilar) treatment in advanced hepatocellular carcinoma (HCC).
A total of 33 patients with advanced HCC were prospectively enrolled and received sintilimab plus IBI305 treatment from November 2018 to October 2019. Baseline characteristics including clinical data, laboratory data, and tumor features based on pretreatment CT/MR were collected. Meanwhile, pretreatment contrast-enhanced ultrasound (CEUS) for target tumor was performed and quantitative parameters were derived from time-intensity curves (TICs). A nomogram was developed based on the variables identified by the univariable and multivariable logistic regression analysis. The discrimination, calibration, and clinical utility of the nomogram were evaluated.
Tumor embolus and grad ratio were significant variables related to the efficacy of sintilimab plus IBI305 strategy. The nomogram based on these two variables achieved an excellent predictive performance with an area under curve (AUC) of 0.909 (95% CI, 0.813-1). A bootstrapping for 500 repetitions was performed to validate this model and the AUC of the bootstrap model was 0.91 (95% CI, 0.8-0.98). The calibration curve and decision curve analysis (DCA) showed that the nomogram had a good consistency and clinical utility.
This study has established and validated a nomogram by incorporating the quantitative parameters of pretreatment CEUS and baseline clinical characteristics to predict the anti-PD-1 plus anti-VEGF treatment efficacy in advanced HCC patients.
目前尚无研究关注特瑞普利单抗（抗 PD-1）联合 IBI305（贝伐珠单抗生物类似药）治疗晚期肝细胞癌（HCC）的疗效的非侵入性预测因子。
共前瞻性纳入 33 例晚期 HCC 患者，自 2018 年 11 月至 2019 年 10 月接受特瑞普利单抗联合 IBI305 治疗。收集基线特征，包括临床数据、实验室数据和基于治疗前 CT/MR 的肿瘤特征。同时，对目标肿瘤进行治疗前超声造影（CEUS）检查，并从时间-强度曲线（TIC）中提取定量参数。基于单变量和多变量逻辑回归分析确定的变量建立列线图。评估列线图的判别、校准和临床实用性。
肿瘤栓子和 grad 比值是与特瑞普利单抗联合 IBI305 策略疗效相关的显著变量。基于这两个变量的列线图具有出色的预测性能，曲线下面积（AUC）为 0.909（95%CI，0.813-1）。通过 500 次重复进行 bootstrap 验证，该模型的 AUC 为 0.91（95%CI，0.8-0.98）。校准曲线和决策曲线分析（DCA）表明，该列线图具有良好的一致性和临床实用性。
本研究建立并验证了一个列线图，该列线图纳入了治疗前 CEUS 的定量参数和基线临床特征，以预测晚期 HCC 患者抗 PD-1 联合抗 VEGF 治疗的疗效。
