CRAFITY 评分在接受仑伐替尼和帕博利珠单抗治疗的肝细胞癌患者中是一个重要的预后指标。
The CRAFITY score emerges as a paramount prognostic indicator in hepatocellular carcinoma patients received Lenvatinib and Pembrolizumab.
机构信息
Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.
出版信息
Front Immunol. 2024 Nov 1;15:1474456. doi: 10.3389/fimmu.2024.1474456. eCollection 2024.
BACKGROUND
Levels of C-reactive protein (CRP) and alpha-fetoprotein (AFP) in immunotherapy (CRAFITY) scores are associated with the prognosis of patients with hepatocellular carcinoma (HCC). This study aimed to explore the efficacy of lenvatinib and pembrolizumab (Len-P) based on the CRAFITY score.
METHODS
In this study, 228 patients with HCC who received Len-P in Sun Yat-sen University Cancer Center were included. CRAFITY 0 score was defined as AFP level below 100 ng/ml, CRP level below 1 mg/dl, CRAFITY 1 score was defined as AFP level at least 100 ng/ml or CRP level at least 1 mg/dl. CRAFITY 2 scores were defined as AFP levels exceeding 100 ng/ml and CRP levels exceeding 100 ng/ml. The primary outcome was overall survival (OS). The second outcome was tumor response rate.
RESULTS
The survival time of CRAFITY 0 is significantly longer than that of CRAFITY 1 and CRAFITY 2 (p =.044). Univariate analysis showed that largest tumor size (HR = 2.149; 95% CI 1.129 - 4.091; p =.02), lymph node metastasis (HR = 2.012; 95% CI 1.132- 3.579; p = .017), and CRAFITY (HR = 0.372; 95% CI 0.168-0.824; p = .015) were important risk determinants of OS in all patients. The results of multivariate analysis show that CRAFITY score is an independent risk factors for OS (HR = 0.719; 95% CI 0.377-1.374; p =.048). The ORR of CRAFITY 0, 1 and 2 scores were 36.4%, 32% and 27.4%, respectively ( = .556). The ORR of intrahepatic lesions by CRAFITY 0, 1 and 2 were 37.9%, 35%, 30.6% (= .688).
CONCLUSION
CRAFITY score is a good predictor of prognosis in HCC patients receiving Len-P.
背景
C 反应蛋白（CRP）和甲胎蛋白（AFP）水平在免疫治疗（CRAFITY）评分中与肝细胞癌（HCC）患者的预后相关。本研究旨在探讨基于 CRAFITY 评分的仑伐替尼和帕博利珠单抗（Len-P）的疗效。
方法
本研究纳入中山大学肿瘤防治中心接受 Len-P 治疗的 228 例 HCC 患者。CRAFITY 0 评分定义为 AFP 水平<100ng/ml，CRP 水平<1mg/dl；CRAFITY 1 评分定义为 AFP 水平至少 100ng/ml 或 CRP 水平至少 1mg/dl；CRAFITY 2 评分定义为 AFP 水平>100ng/ml 且 CRP 水平>100ng/ml。主要终点为总生存期（OS）。次要终点为肿瘤缓解率。
结果
CRAFITY 0 的生存时间明显长于 CRAFITY 1 和 CRAFITY 2（p=.044）。单因素分析显示，最大肿瘤直径（HR=2.149；95%CI 1.129-4.091；p=.02）、淋巴结转移（HR=2.012；95%CI 1.132-3.579；p=.017）和 CRAFITY（HR=0.372；95%CI 0.168-0.824；p=.015）是所有患者 OS 的重要危险因素。多因素分析结果显示，CRAFITY 评分是 OS 的独立危险因素（HR=0.719；95%CI 0.377-1.374；p=.048）。CRAFITY 0、1 和 2 评分的 ORR 分别为 36.4%、32%和 27.4%（=0.556）。CRAFITY 0、1 和 2 评分的肝内病变 ORR 分别为 37.9%、35%和 30.6%（=0.688）。
结论
CRAFITY 评分是预测 HCC 患者接受 Len-P 治疗预后的良好指标。
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