BackgroundThe lung immune prognostic index (LIPI) is recently developed to predict immune checkpoint inhibitors (ICIs) treatment outcomes for non-small cell lung cancer. However, its predictive value for other types of cancer remained unclear. This meta-analysis aimed to evaluate the association between pretreatment LIPI score and therapeutic outcomes in cancer patients treated with ICIs.MethodsWe searched PubMed, Cochrane Library literature databases and EMBASE for abstracts and full-text articles published from the inception of the database until 16th, Nov 2020. Meta-analyses were performed separately for progression-free survival (PFS) and overall survival (OS) by using the random-effects model.ResultsA total of 12 studies involving 4883 patients receiving ICIs treatment were identified for the primary analysis. The pooled results implied that compared with good LIPI score groups, patients with poor or intermediate LIPI score were significantly associated with worse OS (HR=3.33, 95%CI 2.64-4.21, P < 0.001, I2 = 64.2%; HR=1.71, 95%CI 1.43-2.04, P < 0.001, I2 = 43.6%, respectively) and PFS (HR=2.73,95%CI 2.00-3.73, P < 0.001, I2 = 78.2%; HR=1.43, 95%CI 1.28-1.61, P < 0.001, I2 = 16.3%, respectively). Also, for 1873 patients receiving chemotherapy, a poor LIPI score was significantly associated with worse OS (HR=2.30, 95%CI 1.73-3.07, P < 0.001; I2 = 56.2%) and PFS (HR=1.92,95%CI 1.69-2.17; P < 0.001; I2 = 0.0%) compared with good LIPI score groups.ConclusionsA good LIPI score was significantly correlated with improved OS and PFS in cancer patients receiving ICIs or chemotherapy, regardless of the types of cancer.

Background and Aim:The purpose of the present study was to evaluate the effect of direct-acting antivirals (DAAs) therapy on the clinical outcomes of hepatitis C virus (HCV) patients with hepatocellular carcinoma (HCC). Methods: We searched multiple electronic databases from database inception to June 14, 2021. Meta-analyses were performed separately for HCC recurrence and overall survival (OS). Results: A total of 23 studies were identified for the primary analysis. Compared with no intervention, pooled data showed significant benefit from DAAs therapy in reducing recurrence (adjusted HR = 0.55, 95% CI 0.41-0.74, P < 0.001; I 2 = 66.6%, P < 0.001) and improving OS (adjusted HR = 0.36, 95% CI 0.16-0.83, P = 0.017; I 2 = 90.7%, P < 0.001) of HCV-related HCC patients. Compared with non-responders, patients with sustained virologic response (SVR) had greater benefit from DAAs therapy in reducing recurrence (HR = 0.37, 95% CI 0.16-0.84, P = 0.017; I 2 = 58.8%, P = 0.088) and improving OS (HR = 0.17; 95% CI 0.06-0.50; P = 0.001; I 2 = 56.4%, P = 0.130). Though DAAs did not show significant advantages over IFN in reducing recurrence (adjusted HR = 0.96, 95% CI 0.72-1.28, P = 0.784; I 2 = 0.0%, P = 0.805), there seems to be a trend toward OS benefit from DAAs therapy (adjusted HR = 0.11, 95% CI 0.01-1.19, P = 0.059). Conclusion: DAAs therapy can prevent recurrence and improve OS of HCV-related HCC patients, especially for patients with SVR. Further prospective randomized controlled trial is warranted to validate these results.

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Background The purpose of the current study was to investigate the predictive value of hepatitis B core-related antigen (HBcrAg) on the occurrence and recurrence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). Methods Based on PubMed, Embase, Scopus, and Web of Science, we conducted a systematic review and meta-analysis of original clinical literature. The primary outcomes were the occurrence and recurrence of HCC assessed by the hazard ratio (HR) or odds ratio (OR) with 95% confidence interval (CI). Results A total of 18 publications with 9039 CHB patients were included in the preliminary analysis. The pooled results suggest that HBcrAg positivity (adjusted HR = 3.10, 95%CI: 2.07–4.64, P < 0.001, I2 = 62.4%, P = 0.021; OR = 5.65, 95%CI: 3.44–5.82, P < 0.001, I2 = 0.00%, P = 0.42) was an independent risk factor for the occurrence of HCC. Further subgroup analysis revealed that 4.0 logU/ml may be the optimal cut-off value for HBcrAg to predict the occurrence of HCC. Our meta-analysis also suggests that HBcrAg is a predictor of HCC recurrence during antiviral therapy (adjusted HR = 1.71, 95%CI: 1.26–2.32; I2 = 78.6%, P = 0.031) and is closely related to recurrence-free survival (RFS) after curative treatment of HCC (P = 0.001). Conclusion For patients with CHB, serum HBcrAg level is closely associated with the occurrence of HCC, regardless of whether nucleoside/nucleotide analogues (NAs) are administered, may also serve as a novel prognostic biomarker of recurrence in HCC. Confirmation of these findings requires more research.