Comparison of α-Fetoprotein Criteria and Modified Response Evaluation Criteria in Solid Tumors for the Prediction of Overall Survival of Patients with Hepatocellular Carcinoma after Transarterial Chemoembolization

Zhang, Ying-Qiang; Jiang, Lijuan; Wen, Jia; Liu, Di-Min; Huang, Guihua; Wang, Yu; Fan, Wenzhe; Li, Jiaping

doi:10.1016/j.jvir.2018.07.031

Cited by 21 publications

(16 citation statements)

References 31 publications

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“…Elevated preoperative AFP has been associated with recurrence in patients undergoing surgical resection or transplant (3,4). In patients treated with transarterial chemoembolization or surgery, postintervention AFP decreases are associated with improved outcomes, including longer time to progression or recurrence, while increases indicate disease progression (5)(6)(7). Retrospective studies of patients with HCC receiving systemic therapy also suggest an association between AFP decline on treatment and improved survival (8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Serum Alpha-fetoprotein Levels and Clinical Outcomes in the Phase III CELESTIAL Study of Cabozantinib versus Placebo in Patients with Advanced Hepatocellular Carcinoma

Kelley

Meyer

Rimassa

et al. 2020

Clinical Cancer Research

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The phase III CELESTIAL study demonstrated improved overall survival (OS) and progression-free survival (PFS) with cabozantinib versus placebo in patients with previously treated, advanced hepatocellular carcinoma (HCC). We analyzed outcomes by baseline alpha-fetoprotein (AFP) and on-treatment AFP changes. Patients and Methods: Serum AFP was measured every 8 weeks by blinded, centralized testing. Outcomes were analyzed by baseline AFP bifurcated at 400 ng/mL and by on-treatment AFP response (≥20% decrease from baseline at Week 8). The optimal cutoff for change in AFP at Week 8 was evaluated using maximally selected rank statistics. Results: Median OS for cabozantinib versus placebo was 13.9 versus 10.3 months [HR, 0.81; 95% confidence interval (CI), 0.62-1.04] for patients with baseline AFP <400 ng/mL, and 8.5 versus 5.2 months (HR, 0.71; 95% CI, 0.54-0.94) for patients with baseline AFP ≥400 ng/mL. Week 8 AFP response rate was 50% for cabozantinib versus 13% for placebo. In the cabozantinib arm, median OS for patients with and without AFP response was 16.1 versus 9.1 months (HR, 0.61; 95% CI, 0.45-0.84). AFP response was independently associated with longer OS. The optimal cutoff for association with OS in the cabozantinib arm was ≤0% change in AFP at Week 8 [AFP control; HR 0.50 (95% CI, 0.35-0.71)]. HRs for PFS were consistent with those for OS. Conclusions: Cabozantinib improved outcomes versus placebo across a range of baseline AFP levels. On-treatment AFP response and control rates were higher with cabozantinib than placebo, and were associated with longer OS and PFS with cabozantinib.

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Section: Introductionmentioning

confidence: 99%

Serum Alpha-fetoprotein Levels and Clinical Outcomes in the Phase III CELESTIAL Study of Cabozantinib versus Placebo in Patients with Advanced Hepatocellular Carcinoma

Kelley

Meyer

Rimassa

et al. 2020

Clinical Cancer Research

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“…However, two studies have recently reported that CSPH is a major negative prognostic factor in patients treated with DEB-TACE 10,20. It should be noted that the OS of this cohort was lower than that at other sites [21][22][23][24][25][26][27][28][29] (Supplementary table 5),, despite similar patient selection, supra-selective procedures and response to therapy. We speculate that although alcohol aetiology is not an independent predictor of survival, alcohol consumption can impair liver function due to acute-on-chronic liver failure 30 or alcoholic hepatitis 31,32.…”

Section: Discussionmentioning

confidence: 73%

The development of early ascites is associated with shorter overall survival in patients with hepatocellular carcinoma treated with drug-eluting embolic chemoembolization

Pipa-Muniz

Sanmartino

Mesa

et al. 2019

Preprint

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Background: A single-centre cohort study was performed to identify the independent factors associated withthe overall survival (OS) of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization with drug-eluting beads (DEB-TACE). Methods: A total of 216 HCC patients who underwent DEB-TACE from October 2008 to October 2015 at a tertiary hospital were consecutively recruited. The analysis of prognostic factors associated with DEB-TACE complications was performed. Results: The objective response (OR) rate (Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria) to the first DEB-TACE (DEB-TACE-1) was 70.3%; the median OS from DEB-TACE-1 was 27 months (95% confidence interval (CI), 24-30). In the multivariate analysis, basal Barcelona Clinic Liver Cancer (BCLC) stage and serum alkaline phosphatase were independent factors for survival following DEB-TACE-1. The most important clinical event associated with poor survival was the development of early ascites after DEB-TACE-1 (median OS, 17 months), which was closely related to the history of ascites, albumin and hemoglobin but not to tumour load or to response to therapy. Conclusions: Early ascites post-DEB-TACE is associated with the survival of patients despite adequate liver function and the use of a supra-selective technical approach. History of ascites, albumin and hemoglobin are major determinants of the development of early ascites post-DEB-TACE.

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“…That is the case in 71 patients with alcohol related cirrhosis with a first episode of hepatic decompensation that are asymptomatic and compensated after alcohol withdrawal. It should be noted that the OS of this cohort was lower than that at other sites [21][22][23][24][25][26][27][28][29] (Supplementary table 6), despite similar patient selection, supraselective procedures and response to therapy. We speculate that although alcohol aetiology is not an independent predictor of survival, alcohol consumption can impair liver function due to acute-onchronic liver failure [30] or alcoholic hepatitis [31,32].…”

Section: Discussionmentioning

confidence: 74%

The development of early ascites is associated with shorter overall survival in patients with hepatocellular carcinoma treated with drug-eluting embolic chemoembolization

Pipa-Muniz

Sanmartino

Mesa

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: A single-centre cohort study was performed to identify the independent factors associated withthe overall survival (OS) of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization with drug-eluting beads (DEB-TACE). Methods : A total of 216 HCC patients who underwent DEB-TACE from October 2008 to October 2015 at a tertiary hospital were consecutively recruited. The analysis of prognostic factors associated with overall survival after DEB-TACE, stressing the role of post-TACE events, was performed. Results: The objective response (OR) rate (Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria) to the first DEB-TACE (DEB-TACE-1) was 70.3%; the median OS from DEB-TACE-1 was 27 months (95% confidence interval (CI), 24-30). In the multivariate analysis, tumor size, AFP < 100 ng/mL and serum alkaline phosphatase were independent factors for survival following DEB-TACE-1. The most important clinical event associated with poor survival was the development of early ascites after DEB-TACE-1 (median OS, 17 months), which was closely related to the history of ascites, albumin and hemoglobin but not to tumour load or to response to therapy. Conclusions : Early ascites post-DEB-TACE is associated with the survival of patients despite adequate liver function and the use of a supra-selective technical approach. History of ascites, albumin and hemoglobin are major determinants of the development of early ascites post-DEB-TACE.

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Comparison of α-Fetoprotein Criteria and Modified Response Evaluation Criteria in Solid Tumors for the Prediction of Overall Survival of Patients with Hepatocellular Carcinoma after Transarterial Chemoembolization

Cited by 21 publications

References 31 publications

Serum Alpha-fetoprotein Levels and Clinical Outcomes in the Phase III CELESTIAL Study of Cabozantinib versus Placebo in Patients with Advanced Hepatocellular Carcinoma

Serum Alpha-fetoprotein Levels and Clinical Outcomes in the Phase III CELESTIAL Study of Cabozantinib versus Placebo in Patients with Advanced Hepatocellular Carcinoma

The development of early ascites is associated with shorter overall survival in patients with hepatocellular carcinoma treated with drug-eluting embolic chemoembolization

The development of early ascites is associated with shorter overall survival in patients with hepatocellular carcinoma treated with drug-eluting embolic chemoembolization

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