Department of Oncology, The Fifth Hospital of Wuhan, #122 Xianzheng Road, Hanyang District, Wuhan, 430000, China.
Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China.
BMC Cancer. 2023 Oct 19;23(1):1006. doi: 10.1186/s12885-023-11488-9.
The use of regorafenib in the treatment of hepatocellular carcinoma (HCC) is widespread. Albumin-Bilirubin (ALBI) has been shown to be a potential prognostic marker for regorafenib treatment, but its prognostic value remains controversial. Therefore, we conducted a meta-analysis to investigate the value of the baseline ALBI grade in predicting the efficacy and survival outcomes of HCC patients after regorafenib treatment.
PubMed, Embase, Cochrane library, Web of Science, CNKI, Wan Fang Data, and Vip Database were searched from January 2010 to October 2022. Studies treating HCC patients with regorafenib and with ALBI as a categorical variable, overall survival (OS) and progression-free survival (PFS) as outcome indicators were included. After applying Newcastle-Ottawa Scale (NOS) to evaluate the quality of the included studies, Review Manager 5.4 was used to statistically analyze. Chi-square Q test and I statistics were used to detect heterogeneity. Funnel plot asymmetry, Egger's and Begg's test were used to evaluate publication bias.
A total of 12 studies, comprising 1,918 patients, were included in the meta-analysis. The included studies were all evaluated as high quality. Compared to the high-grade baseline ALBI group, patients in the low-grade group had a longer survival time after receiving regorafenib and also more suitable for regorafenib treatment [odds ratio (OR) = 6.50, 95% confidence interval (CI): 2.22-18.96, P < 0.01]. The low-grade baseline ALBI group before sorafenib treatment was significantly correlated with better OS [hazard ratio (HR) = 2.36, 95% CI: 1.68-3.31, P < 0.00001] and PFS (HR = 1.56, 95% CI: 1.16-2.08, P = 0.003). Likewise, the low-grade baseline ALBI group before regorafenib was also significantly correlated with better OS (HR = 1.56, 95% CI: 1.15-2.13, P = 0.005) and PFS (HR = 2.06, 95% CI: 1.37-3.11, P = 0.0005). In addition, the ALBI grade was significantly correlated with disease control rate (DCR) (OR = 2.90, 95% CI: 1.45-5.79, P = 0.003), but not the objective response rate (OR = 1.98, 95% CI: 0.71-5.46, P = 0.19).
The baseline ALBI grade could be a valuable prognostic indicator for predicting response and outcomes in HCC patients treated with regorafenib.
瑞戈非尼在肝细胞癌（HCC）的治疗中广泛应用。ALBI 分级已被证明是瑞戈非尼治疗的潜在预后标志物，但它的预后价值仍存在争议。因此，我们进行了一项荟萃分析，以探讨基线 ALBI 分级在预测 HCC 患者接受瑞戈非尼治疗后的疗效和生存结局方面的价值。
检索 2010 年 1 月至 2022 年 10 月期间 PubMed、Embase、Cochrane 图书馆、Web of Science、CNKI、万方数据和维普数据库，纳入以瑞戈非尼治疗 HCC 患者且 ALBI 为分类变量、总生存期（OS）和无进展生存期（PFS）为结局指标的研究。应用 Newcastle-Ottawa 量表（NOS）对纳入研究的质量进行评价后，采用 Review Manager 5.4 进行统计学分析。采用 Chi-square Q 检验和 I ² 统计量检测异质性。采用漏斗图不对称、Egger's 和 Begg's 检验评估发表偏倚。
共纳入 12 项研究，包含 1918 例患者，纳入的研究均被评为高质量研究。与基线 ALBI 分级较高的患者相比，接受瑞戈非尼治疗后基线 ALBI 分级较低的患者具有更长的生存时间，且更适合接受瑞戈非尼治疗[比值比（OR）=6.50，95%置信区间（CI）：2.22-18.96，P<0.01]。基线 ALBI 分级较低的患者在接受索拉非尼治疗前，与 OS 显著相关[风险比（HR）=2.36，95%CI：1.68-3.31，P<0.00001]和 PFS（HR=1.56，95%CI：1.16-2.08，P=0.003）。同样，基线 ALBI 分级较低的患者在接受瑞戈非尼治疗前，与 OS 也显著相关（HR=1.56，95%CI：1.15-2.13，P=0.005）和 PFS（HR=2.06，95%CI：1.37-3.11，P=0.0005）。此外，ALBI 分级与疾病控制率（DCR）显著相关（OR=2.90，95%CI：1.45-5.79，P=0.003），但与客观缓解率（OR=1.98，95%CI：0.71-5.46，P=0.19）无关。
基线 ALBI 分级可能是预测 HCC 患者接受瑞戈非尼治疗后反应和结局的有价值的预后指标。
