血清CRP水平对接受度伐鲁单抗和曲美木单抗治疗的晚期肝癌的临床影响：一项多中心研究
Clinical Impact of Serum CRP Levels on Advanced HCC Treated With Durvalumab and Tremelimumab: A Multicentre Study.
作者信息
Hatanaka Takeshi, Yata Yutaka, Hiraoka Atsushi, Tada Toshifumi, Hirooka Masashi, Kariyama Kazuya, Tani Joji, Atsukawa Masanori, Takaguchi Koichi, Itobayashi Ei, Kakizaki Satoru, Fukunishi Shinya, Tsuji Kunihiko, Ishikawa Toru, Tajiri Kazuto, Toyoda Hidenori, Koshiyama Yuichi, Ogawa Chikara, Nishikawa Hiroki, Nishimura Takashi, Kawata Kazuhito, Kosaka Hisashi, Matsui Kosuke, Naganuma Atsushi, Tanaka Hironori, Ohama Hideko, Kuroda Hidekatsu, Matono Tomomitsu, Aoki Tomoko, Ochi Hironori, Imai Michitaka, Nakamura Shinichiro, Kanayama Yuki, Tanaka Kazunari, Tada Fujimasa, Yoshida Osamu, Nouso Kazuhiro, Morishita Asahiro, Tsutsui Akemi, Nagano Takuya, Itokawa Norio, Okubo Tomomi, Arai Taeang, Enomoto Hirayuki, Kaibori Masaki, Hiasa Yoichi, Kudo Masatoshi, Kumada Takashi
机构信息
Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Department of Gastroenterology, Hanwa Memorial Hospital, Osaka, Japan.
出版信息
Liver Int. 2025 Jul;45(7):e70192. doi: 10.1111/liv.70192.
AIM
This study aimed to evaluate the therapeutic efficacy and prognostic significance of C-reactive protein (CRP) in patients with advanced hepatocellular carcinoma (HCC) receiving durvalumab and tremelimumab (Dur/Tre).
METHODS
A total of 167 patients treated with Dur/Tre between March 2023 and March 2024 in Japanese hospitals were included in this retrospective multicentre study. Patients were divided into two groups based on pre-treatment serum CRP levels: the low-CRP group (< 1 mg/dL, n = 106) and the high-CRP group (≥ 1 mg/dL, n = 61).
RESULTS
The median age of the cohort was 74.0 years (interquartile range, 67.5-79.5), and 139 patients (83.2%) were male. The median progression-free survival (PFS) was 3.6 months (95% CI: 2.6-5.4) in the low-CRP group and 2.4 months (95% CI: 1.9-4.1) in the high-CRP group, with statistical significance (p = 0.02). The median overall survival (OS) was not reached in the low-CRP group, with a 1-year survival rate of 64.7% (95% CI: 49.0-76.7), while it was 7.9 months (95% CI: 5.8-11.8) in the high-CRP group. The low-CRP group demonstrated significantly better survival outcomes compared to the high-CRP group (p < 0.001). Multivariate analysis identified serum CRP level as an independent predictive factor for both PFS and OS (p = 0.04 and < 0.001, respectively). No significant differences in immune-related adverse events were observed between the two groups.
CONCLUSIONS
Serum CRP may serve as a prognostic biomarker in HCC patients receiving Dur/Tre, with a potential association with treatment efficacy.
目的
本研究旨在评估C反应蛋白（CRP）在接受度伐利尤单抗和曲美木单抗（Dur/Tre）治疗的晚期肝细胞癌（HCC）患者中的治疗效果和预后意义。
方法
本项回顾性多中心研究纳入了2023年3月至2024年3月期间在日本医院接受Dur/Tre治疗的167例患者。根据治疗前血清CRP水平将患者分为两组：低CRP组（<1mg/dL，n = 106）和高CRP组（≥1mg/dL，n = 61）。
结果
该队列的中位年龄为74.0岁（四分位间距，67.5 - 79.5），139例患者（83.2%）为男性。低CRP组的中位无进展生存期（PFS）为3.6个月（95%CI：2.6 - 5.4），高CRP组为2.4个月（95%CI：1.9 - 4.1），差异具有统计学意义（p = 0.02）。低CRP组的中位总生存期（OS）未达到，1年生存率为64.7%（95%CI：49.0 - 76.7），而高CRP组为7.9个月（95%CI：5.8 - 11.8）。与高CRP组相比，低CRP组的生存结局明显更好（p < 0.001）。多因素分析确定血清CRP水平是PFS和OS的独立预测因素（分别为p = 0.04和<0.001）。两组之间在免疫相关不良事件方面未观察到显著差异。
结论
血清CRP可能作为接受Dur/Tre治疗的HCC患者的预后生物标志物，与治疗效果可能存在关联。
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