Yao Yang, Zhang Minyue, Liu Di, Liu Xiaoni, Li Quanwei, Wang Xiaojun
Department of Integrated Traditional Chinese and Western Medicine, Beijing Youan Hospital, Capital Medical University, No. 8 Xi Tou Tiao, You An Men Wai, Feng Tai District, Beijing, 100069, China.
Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, No. 8 Xi Tou Tiao, You An Men Wai, Feng Tai District, Beijing, 100069, China.
Clin Transl Oncol. 2025 Mar;27(3):1155-1165. doi: 10.1007/s12094-024-03596-0. Epub 2024 Aug 17.
This study aimed to evaluate the prognostic significance of changes in inflammatory markers in patients with Hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) treated with first-line lenvatinib plus a programmed cell death protein 1 (PD-1) inhibitor.
This study retrospectively included 117 HBV-HCC patients treated with first-line lenvatinib in combination with a PD-1 inhibitor. Independent factors affecting progression-free survival (PFS) and overall survival (OS) were explored based on baseline indicators and inflammatory markers changes after one treatment cycle.
Multivariate analysis revealed that an alpha-fetoprotein (AFP) level 400 ng/mL [hazard ratio (HR), 1.69; 95% confidence interval (CI), 1.11-2.58; P = 0.01] was identified as an independent risk factor, platelet-to-neutrophil ratio (PNR) 65.43 (HR 0.50; 95% CI 0.30-0.84; P and SII 539.47 (HR 0.54; 95% CI 0.30-0.96; P = 0.03) were identified as independent protective factors for PFS. Additionally, multivariate analysis demonstrated that AFP 400 ng/mL, HBV-HCC patients with diabetes mellitus (DM), and SII were independent risk factors of OS. The patients whose SII had increased after one cycle of treatment showed a poorer PFS (HR 1.61; 95 %CI 1.10-2.37; P = 0.015) and OS (HR 1.76; 95 % CI 1.15-2.70; P = 0.009) than patients whose SII had decreased. The objective response rate (ORR) was higher in the SII-decreased patients (47.5% vs 32.5%, P = 0.11). Mann-Whitney test found a significant difference in therapeutic response between the SII-increased patients and the SII-decreased patients (P = 0.04).
SII can be associated with outcomes in patients with HBV-HCC treated with first-line lenvatinib plus PD-1 inhibitors.
本研究旨在评估一线使用乐伐替尼联合程序性细胞死亡蛋白1（PD-1）抑制剂治疗的乙型肝炎病毒相关肝细胞癌（HBV-HCC）患者炎症标志物变化的预后意义。
本研究回顾性纳入了117例接受一线乐伐替尼联合PD-1抑制剂治疗的HBV-HCC患者。基于基线指标和一个治疗周期后的炎症标志物变化，探讨影响无进展生存期（PFS）和总生存期（OS）的独立因素。
多因素分析显示，甲胎蛋白（AFP）水平>400 ng/mL（风险比[HR]，1.69；95%置信区间[CI]，1.11-2.58；P = 0.01）被确定为独立危险因素，血小板与中性粒细胞比值（PNR）>65.43（HR 0.50；95% CI 0.30-0.84；P<0.01）和全身炎症反应指数（SII）>539.47（HR 0.54；95% CI 0.30-0.96；P = 0.03）被确定为PFS的独立保护因素。此外，多因素分析表明，AFP>400 ng/mL、合并糖尿病（DM）的HBV-HCC患者和SII是OS的独立危险因素。治疗一个周期后SII升高的患者的PFS（HR 1.61；95%CI 1.10-2.37；P = 0.015）和OS（HR 1.76；95% CI 1.15-2.70；P = 0.009）均比SII降低的患者差。SII降低的患者客观缓解率（ORR）更高（47.5%对32.5%，P = 0.11）。曼-惠特尼检验发现SII升高的患者和SII降低的患者之间治疗反应存在显著差异（P = 0.04）。
SII可能与一线使用乐伐替尼联合PD-1抑制剂治疗的HBV-HCC患者的预后相关。
