Analyses of Intermediate-Stage Hepatocellular Carcinoma Patients Receiving Transarterial Chemoembolization prior to Designing Clinical Trials

Koroki, Keisuke; Ogasawara, Sadahisa; Ooka, Yoshihiko; Kanzaki, Hiroaki; Kanayama, Kengo; Maruta, Susumu; Maeda, Takahiro; Yokoyama, Masayuki; Wakamatsu, Toru; Inoue, Masatoshi; Kobayashi, Kazufumi; Kiyono, Soichiro; Nakamura, Masato; Kanogawa, Naoya; Saito, Tomoko; Kondo, Takayuki; Suzuki, Eiichiro; Nakamoto, Shingo; Yasui, Shin; Tawada, Akinobu; Chiba, Tetsuhiro; Arai, Makoto; Maruyama, Hitoshi; Kato, Jun; Kuboki, Satoshi; Ohtsuka, Masayuki; Miyazaki, Masaru; Yokosuka, Osamu; Kato, Naoya

doi:10.1159/000508809

Cited by 16 publications

(13 citation statements)

References 49 publications

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“…Patients who were beyond up-to-seven criteria were defined as: largest tumor diameter (cm) + number of tumors >7. 26 Progression-free survival (PFS) was calculated from the date of diagnosis to the date of tumor progression and tumor progression was assessed based on the 2019 version of Response Evaluation Criteria in Cancer of the Liver (RECICL), which was defined as tumor enlargement of ≥50%, excluding the area of treatment-induced necrosis in either target lesion or non-target lesion. 27 Overall survival (OS) was calculated from the date of diagnosis to the date of death due to any reason or to the date of the last followup.…”

Section: Response Evaluation and Follow-upmentioning

confidence: 99%

Systemic Inflammation Response Index is a Prognostic Risk Factor in Patients with Hepatocellular Carcinoma Undergoing TACE

Wang¹,

An²,

Li³

et al. 2021

RMHP

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Background: Mounting evidence has shown that systemic inflammation response index (SIRI), a novel prognostic biomarker based on peripheral lymphocyte, neutrophil and monocyte counts, is associated with poor prognosis for several tumors. However, the prognostic value of SIRI in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) is elusive. Herein, we aimed to evaluate the correlation between SIRI and clinical outcomes in these patients. Methods: A total of 194 consecutive patients who underwent TACE were included in this study. Patients were stratified into high and low SIRI groups based on the cut-off value using receiver operating characteristic (ROC) analysis. Independent risk factors for tumor response were analyzed using forward stepwise logistic regression. A one-to-one propensity score matching (PSM) was conducted to compare progression-free survival (PFS) and overall survival (OS) between low and high SIRI patients. The discriminatory power of the combination of number of tumors and SIRI in predicting initial TACE response was evaluated by ROC analysis. Results: Patients were divided into high SIRI (> 0.88) and low SIRI (≤ 0.88) groups. High SIRI (p = 0.003) and more than three tumors (p = 0.002) were significantly related to poorer tumor response. Moreover, the low SIRI group had longer PFS and OS than the high SIRI group (both P < 0.05) before and after PSM. Combination of SIRI and number of tumors can improve the predictive ability to predict initial TACE response with an area under the curve (AUC) of 0.678. Conclusion:Pretreatment peripheral blood SIRI was found to be an independent predictor of tumor response and clinical outcomes in patients with HCC undergoing TACE. Patients with high SIRI may have a poor prognosis.

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Section: Response Evaluation and Follow-upmentioning

confidence: 99%

Systemic Inflammation Response Index is a Prognostic Risk Factor in Patients with Hepatocellular Carcinoma Undergoing TACE

Wang¹,

An²,

Li³

et al. 2021

RMHP

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“…The radiological data included tumor distribution (unilobar/bilobar), number of tumors (solitary/2–3/>3), size of the largest tumor, and up-to-seven criteria (within/beyond). Patients who were beyond up-to-seven criteria was defined as: largest tumor diameter [cm] + number of tumors >7 ( Mazzaferro et al, 2009 ; Koroki et al, 2020 ). Radiological data were independently reviewed by two radiologists with either 22 or 19 years of experience of abdominal imaging, respectively.…”

Section: Methodsmentioning

confidence: 99%

Development and Validation of a Predictive Model for Early Refractoriness of Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma

Wang

et al. 2021

Front. Mol. Biosci.

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Objectives: To develop and validate a predictive model for early refractoriness of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).Methods: In this multicenter retrospective study, a total of 204 consecutive patients who initially underwent TACE were included. Early TACE refractoriness was defined as patients presented with TACE refractoriness after initial two consecutive TACE procedures. Of all patients, 147 patients (approximately 70%) were assigned to a training set, and the remaining 57 patients (approximately 30%) were assigned to a validation set. Predictive model was established using forward stepwise logistic regression and nomogram. Based on factors selected by logistic regression, a one-to-one propensity score matching (PSM) was conducted to compare progression-free survival (PFS) between patients who were present or absent of early TACE refractoriness. PFS curve was estimated by Kaplan-Meier method and compared by log-rank test.Results: Logistic regression revealed that bilobar tumor distribution (p = 0.002), more than three tumors (p = 0.005) and beyond up-to-seven criteria (p = 0.001) were significantly related to early TACE refractoriness. The discriminative abilities, as determined by the area under the receiver operating characteristic (ROC) curve, were 0.788 in the training cohort and 0.706 in the validation cohort. After PSM, the result showed that patients who were absent of early TACE refractoriness had a significantly higher PFS rate than those of patients who were present (p < 0.001).Conclusion: This study presents a predictive model with moderate accuracy to identify patients with high risk of early TACE refractoriness, and patients with early TACE refractoriness may have a poor prognosis.

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Section: Localized Treatments In Hccmentioning

confidence: 99%

“…TACE is not a radical treatment, which may lead to poor results such as deterioration of liver function and extrahepatic metastasis 186 , 187 . Koroki K et al studied and evaluated the therapeutic effect of TCAE in patients with medium-term HCC 186 . Studies had shown that the results of TACE in patients with medium-term HCC were closely related to the number and size of tumors.…”

Section: Localized Treatments In Hccmentioning

confidence: 99%

New insights into checkpoint inhibitor immunotherapy and its combined therapies in hepatocellular carcinoma: from mechanisms to clinical trials

Jin¹,

Qin²,

He³

et al. 2022

Int. J. Biol. Sci.

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Hepatocellular carcinoma (HCC) is one of the most lethal tumors in China and worldwide, although first-line therapies for HCC, such as atezolizumab and bevacizumab, have been effective with good results, the researches on new therapies have attracted much attention. With the deepening research on tumor immunology, the role and operation mechanism of immune cells in the tumor microenvironment (TME) of HCC have been explained, such as programmed cell death protein 1 (PD-1) binding to ligand could cause T cell exhaustion and reduce IFN-γ T cell secretion, cytotoxic T lymphocyte 4 (CTLA-4) and CD28 mediate immunosuppression by competing for B7 protein and disrupting CD28 signal transduction pathway, which also lays the foundation for the development and application of more new immune checkpoint inhibitors (ICIs). The biological behavior of various immune checkpoints has been proved in HCC, such as PD-1, programmed cell death ligand 1 (PD-L1), CTLA-4 and so on, leading to a series of clinical trials. Currently, FDA approved nivolumab, pembrolizumab and nivolumab plus ipilimumab for the treatment of HCC. However, the treatment of ICI has the disadvantages of low response rate and many side effects, so the combination of ICIs and various other therapies (such as VEGF or VEGFR inhibition, neoadjuvant and adjuvant therapy, locoregional therapies) has been derived. Further studies on immune checkpoint mechanisms may reveal new therapeutic targets and new combination therapies in the future.

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Analyses of Intermediate-Stage Hepatocellular Carcinoma Patients Receiving Transarterial Chemoembolization prior to Designing Clinical Trials

Cited by 16 publications

References 49 publications

Systemic Inflammation Response Index is a Prognostic Risk Factor in Patients with Hepatocellular Carcinoma Undergoing TACE

Systemic Inflammation Response Index is a Prognostic Risk Factor in Patients with Hepatocellular Carcinoma Undergoing TACE

Development and Validation of a Predictive Model for Early Refractoriness of Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma

New insights into checkpoint inhibitor immunotherapy and its combined therapies in hepatocellular carcinoma: from mechanisms to clinical trials

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