Evaluation of prognostic scores in HCC patients undergoing 1L immunotherapy with atezolizumab and bevacizumab

Immunotherapy with atezolizumab and bevacizumab (a+b) has improved prognosis of patients with unresectable hepatocellular carcinoma (HCC). However, the outcome for individual patients is highly variable. This study aimed to i) develop and validate a prognostic prediction model to estimate individual...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:JHEP reports 2024-12, p.101295, Article 101295
Hauptverfasser: Gairing, Simon Johannes, Mildenberger, Philipp, Gile, Jennifer, Artusa, Fabian, Scheiner, Bernhard, Leyh, Catherine, Lieb, Sabine, Sinner, Friedrich, Jörg, Vincent, Fruendt, Thorben, Himmelsbach, Vera, Abedin, Nada, Sahin, Cennet, Böttcher, Katrin, Schuhbaur, Jasmin, Labuhn, Simon, Korolewicz, James, Fulgenzi, Claudia A.M., D'Alessio, Antonio, Zanuso, Valentina, Hucke, Florian, Röhlen, Natascha, Ben Khaled, Najib, Ramadori, Eleonora, Müller, Lukas, Weinmann, Arndt, Kloeckner, Roman, Galle, Peter Robert, Tran, Nguyen H., Venkatesh, Sudhakar K., Teufel, Andreas, Ebert, Matthias, De Toni, Enrico N., Waldschmidt, Dirk-Thomas, Marquardt, Jens U., Bettinger, Dominik, Peck-Radosavljevic, Markus, Geier, Andreas, Reiter, Florian P., Rimassa, Lorenza, Pinato, David J., Roderburg, Christoph, Ettrich, Thomas, Bitzer, Michael, Scheble, Veit, Ehmer, Ursula, Berres, Marie-Luise, Finkelmeier, Fabian, Gonzalez-Carmona, Maria Angeles, von Felden, Johann, Schulze, Kornelius, Venerito, Marino, van Bömmel, Florian, Jochheim, Leonie S., Pinter, Matthias, Mohr, Raphael, Ilyas, Sumera I., Schmidtmann, Irene, Foerster, Friedrich
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Immunotherapy with atezolizumab and bevacizumab (a+b) has improved prognosis of patients with unresectable hepatocellular carcinoma (HCC). However, the outcome for individual patients is highly variable. This study aimed to i) develop and validate a prognostic prediction model to estimate individual prognosis and ii) compare it with established models. In this multicenter retrospective study, HCC patients undergoing 1L immunotherapy with a+b from 24 centers (Europe, US) were included. Statistical analysis and reporting followed the TRIPOD guidelines. The primary objective was overall survival (OS). A Cox model was developed and externally validated. In total, 683 patients were included (training: 526, validation: 157). C-reactive protein, albumin, bilirubin, lymphocytes, ECOG performance status, and extrahepatic spread (CABLE score) remained significantly associated with OS in Cox regression analysis. In the training set, the CABLE score had a higher discriminatory accuracy relative to ALBI, EZ-ALBI, mALBI, CRAFITY, PNI, NLR, PLR, and GPS (time-dependent AUC 0.79 and C-index 0.75 (95% CI 0.71-0.78) at 12 months). In the external validation set, the discriminatory performance of the CABLE score was comparable to ALBI, EZ-ALBI, and mALBI, but on average higher than PNI, CRAFITY, NLR, PLR, and GPS. In patients with Child-Pugh A, the CABLE score outperformed ALBI, EZ-ALBI, and mALBI in the first 9 months. We provide a web-based calculator for the CABLE score to allow estimation of individual prognosis for these patients (http://shiny.imbei.uni-mainz.de:3838/CABLE_Score/). The CABLE score shows good discriminatory performance in assessing the individual prognosis of patients undergoing 1L immunotherapy with a+b. Further validation studies are needed to investigate its performance compared to the ALBI score, in particular in subgroup analysis. The CABLE score allows to estimate prognosis of patients with uHCC undergoing 1L immunotherapy with a+b at an individual level using our web-based calculator. This feature as well as the evaluation of the score’s added benefit through an extensive comparison with other established scores can inform clinicians on their significance and may guide clinical decision-making in the context of a malignant disease whose prognosis has become highly variable. Further large validation studies are needed to investigate the incremental value of the CABLE score compared to the ALBI score, in particular in subgroups such as Child-Pugh A
ISSN:2589-5559
2589-5559
DOI:10.1016/j.jhepr.2024.101295