Hepatocellular carcinoma with complete response to the immunotherapy: the oncologist’s dilemma

Al-Moundhri, Mansour; Cubisino, Antonio; Panaro, Fabrizio

doi:10.21037/hbsn-21-499

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Despite significant advances in the combined immunotargeting therapy ( 8 , 29 ), more clinical research is needed to address the emerging dilemma of immunotherapy, such as developing appropriate tumor response assessment criteria and discovering more noninvasive and practical biomarkers ( 30 ). A more appropriate tumor response assessment criteria calls for a fact that imaging evaluation cannot be used in isolation to judge clinical benefit of immunotherapy.…”

Section: Introductionmentioning

confidence: 99%

The combination of a prolonged treatment time window and alpha-fetoprotein benefits the tumor response of hepatocellular carcinoma patients as evaluated by the imRECIST: a single-center, retrospective study

Yin¹,

Li²,

Li³

et al. 2023

J Gastrointest Oncol

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Background The combined immunotargeting therapy of hepatocellular carcinoma (HCC) have brought remarkable results. There are still some drawbacks to the application of the immune-modified Response Evaluation Criteria in Solid Tumors to Immunotherapy (imRECIST). How many weeks does it take to confirm the true disease progression for HCC patients who had reported disease progression for the first time based on imRECIST. Whether alpha-fetoprotein (AFP), an important indicator in the progression and prognosis of liver cancer, has the same value in immunotherapy. This prompted more clinical data to gather evidence that the immunotherapy time window issue contradicts the potential benefit of therapy. Methods This study retrospectively analyzed the clinical data of 32 patients who had undergone immunotherapy plus targeted therapy at the First Affiliated Hospital of Chongqing Medical University from June 2019 to June 2022. ImRECIST was used to evaluate the therapeutic efficacy among the patients. Before initial treatment and each immunotherapy cycle, each patient underwent standard abdominal computed tomography (CT) imaging and some biochemical indicators to assess physical condition and tumor response. All patients included will be divided into 8 groups. The differences in the survival outcomes of each treatment group were analysed. Results Among the 32 advanced HCC patients, 9 patients achieved stable disease (SD), 12 patients showed progressive disease (PD), 3 patients showed a complete response (CR), and 8 patients showed a partial response (PR). There is no difference in baseline characteristics between subgroups. In relation to patients with PD, a prolonged therapeutic time window and the provision of continuous medication may lead to a PR, prolonging their overall survival (P=0.5864). Compared to the patients with continuous PD, there was no significant difference in the survival of patients with increased AFP concentrations after treatment who achieved PR or SD and ultimately showed PD (P=0.6600). Conclusions In our study, the time window for treatment may need to be extended in the process of immunotherapy for HCC patients. An analysis of AFP may assist the imRECIST by providing a more accurate evaluation of tumor progression.

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Section: Introductionmentioning

confidence: 99%

The combination of a prolonged treatment time window and alpha-fetoprotein benefits the tumor response of hepatocellular carcinoma patients as evaluated by the imRECIST: a single-center, retrospective study

Yin¹,

Li²,

Li³

et al. 2023

J Gastrointest Oncol

View full text Add to dashboard Cite

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“…NACT plays an important and irreplaceable role in tumor reduction, obtaining surgical indications, and improving prognosis in the field of CRLM ( 5 ). However, response rates to NACT vary considerably among patients ( 6 ). Those who exhibit favorable responses to NACT often experience better prognostic outcomes compared to those with inadequate responses.…”

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confidence: 99%