&lt;p&gt;Prognostic Significance of Serum Insulin-Like Growth Factor-1 in Hepatocellular Cancer Patients: A Validation Study&lt;/p&gt;

Laçin, Şahin; Yalçın, Şuayib; Karakaş, Yusuf; Hassan, Manal M.; Amin, Hesham M.; Mohamed, Yehia I.; Rashid, Asif; Morris, Jeffrey S.; Xiao, Lianchun; Qayyum, Aliya; Kaseb, Ahmed O.

doi:10.2147/jhc.s258930

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Subsequently, we prospectively validated a revised CTP scoring system by replacing the subjective clinical assessment of ascites and encephalopathy in the CTP score with objectively quantified plasma IGF-1 levels to create new IGF/CTP score classes (IGF/CTP-A, -B, and -C, with A indicating low risk, B indicating intermediate risk, and C indicating high risk). This new scoring system was significantly associated with HCC survival prediction [21][22][23]. In addition, our results showed that a significant number of patients in the old CTP class A were reassigned as IGF/ CTP-B or -C and had significantly poorer survival than did those in IGF/CTP-A, proving the usefulness of the IGF/ CTP composite score to refine the CTP scoring system's prognostic accuracy.…”

Section: Introductionmentioning

confidence: 56%

Insulin-like growth factor 1/Child-Turcotte-Pugh composite score as a predictor of treatment outcomes in patients with advanced hepatocellular carcinoma treated with sorafenib

et al. 2021

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Background: Sorafenib was the first systemic therapy approved for the treatment of Child-Turcotte-Pugh (CTP) class A patients with advanced hepatocellular carcinoma (HCC). However, there are no biomarkers to predict survival and treatment outcomes and guide HCC systemic therapy. Type 1 insulin-like growth factor (IGF-1)/CTP composite score has emerged as a potential hepatic reserve assessment tool. Our study investigated the association of the IGF/CTP score with overall survival (OS) and progression-free survival (PFS) of HCC patients treated with sorafenib. Materials and Methods: In this prospective study, patients with HCC were treated with sorafenib and followed up until progression/death. We calculated the IGF/CTP score and used the Kaplan-Meier method and log-rank test to estimate and compare the time-to-event outcomes between patient subgroups. Results: 171 patients were included, 116 of whom were CTP class A. Median PFS for IGF/CTP score AA and AB patients were 6.88 and 4.28 months, respectively ( p = 0.1359). Median OS for IGF/CTP score AA and AB patients were 14.54 and 7.60 months, respectively ( p = 0.1378). The PFS and OS was superior in AA patients, but the difference was not significant, likely due to the sample size. However, there was a significant difference in early OS and PFS curves between AA and AB ( p = 0.0383 and p = 0.0099), respectively. Conclusions: In CTP class A patients, IGF/CTP score B was associated with shorter PFS and OS, however, study was underpowered to reach statistical significance. If validated in larger cohorts, IGF/CTP score may serve as stratification tool in clinical trials, a hepatic reserve assessment tool for HCC outcomes prediction and to assist in therapy decisions.

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Section: Introductionmentioning

confidence: 56%

Insulin-like growth factor 1/Child-Turcotte-Pugh composite score as a predictor of treatment outcomes in patients with advanced hepatocellular carcinoma treated with sorafenib

et al. 2021

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“…Finally, in a more recent cohort in which many patients (42.8%) had underlying HBV as the primary etiology of the tumor, 51.8% of the patients were reclassified; however, IGF-CTP scores did not predict OS better than the original CTP scores. 9 Collectively, the patients in these cohorts had heterogeneous demographics, underlying risk factors, HCC stages, and treatments that may have independently affected their survival. More importantly, these studies were retrospective and were not powered to detect significant differences in patient risk stratification and in predicting OS with the IGF-CTP and the original CTP scoring systems.…”

Section: Discussionmentioning

confidence: 99%

“…8 This new scoring system, the IGF-CTP classification system, was validated as a means to assess hepatic reserve in different cohorts of patients with HCC and showed promising but inconclusive results regarding the prediction of OS and patient stratification compared with the CTP scoring system. 5,[9][10][11][12] Notably, these studies were not randomized and had relatively few patients; therefore, they were underpowered to test the superiority of IGF-CTP.…”

Section: Introductionmentioning

confidence: 99%

Serum IGF-1 Scores and Clinical Outcomes in the Phase III IMbrave150 Study of Atezolizumab Plus Bevacizumab versus Sorafenib in Patients with Unresectable Hepatocellular Carcinoma

Kaseb¹,

Guan²,

Yavuz³

et al. 2022

JHC

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Purpose Child-Turcotte-Pugh class A (CTP-A) in unresectable hepatocellular carcinoma (HCC) is the standard criterion for active therapy and clinical trial enrollment. We hypothesized that insulin-like growth factor-1 (IGF-1) derived scores may provide improved survival prediction over CTP classification. This study aimed to evaluate the potential prognostic and predictive effects of IGF-1 derived scores in the phase III IMbrave150 study. Patients and Methods Baseline and on-treatment serum IGF-1 levels from 371 patients were subjected to central analysis. Patients’ IGF-1 score (1/2/3) and IGF-CTP score (A/B/C) were determined based on pre-specified cutoffs. Outcomes were analyzed by baseline and by on-treatment changes of the IGF-1 and IGF-CTP scores within and between the two treatment arms. The interaction between these scores and outcomes was assessed using univariate and multivariate analyses. Results Baseline IGF-CTP score (A vs B/C) showed prognostic significance for OS in both the atezolizumab-bevacizumab (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.20–0.56; P <0.001) and sorafenib (HR, 0.32; 95% CI, 0.16–0.65; P =0.002) arms. Baseline IGF-1 score (1 vs 2/3) also showed prognostic significance for OS in both the atezolizumab-bevacizumab (HR, 0.33; 95% CI, 0.20–0.55; P <0.001) and sorafenib (HR, 0.48; 95% CI, 0.26–0.89; P =0.02) arms. HRs for PFS were consistent with those for OS. No significant predictive effects were observed for either score between the two arms. Kinetic analysis revealed that patients with increased IGF-1 score (1-> 2/3) at 3 weeks post treatment had shorter OS than patients with stable IGF-1 score of 1 in both the atezolizumab-bevacizumab (HR, 3.70; 95% CI, 1.56–8.77; P =0.003) and sorafenib (HR, 5.83; 95% CI, 1.88–18.12; P =0.0023) arms. Conclusion Baseline and kinetic change of IGF-CTP and IGF-1 scores are independent prognostic factors for patients with unresectable HCC treated with atezolizumab-bevacizumab or sorafenib. These novel scores may provide improved patient stratification in future HCC clinical trials. IMbrave150 ClincialTrials.gov number, NCT03434379.

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“…A correlation was found between the intensity of cirrhosis and the onset of HCC and low serum IGF-1 concentration. 46 , 47 …”

Section: Classification Of Hccmentioning

confidence: 99%

A Post-International Gastrointestinal Cancers’ Conference (IGICC) Position Statements

Yalcin,

Lacin,

Kaseb

et al. 2024

JHC

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Hepatocellular carcinoma (HCC), the most prevalent liver tumor, is usually linked with chronic liver diseases, particularly cirrhosis. As per the 2020 statistics, this cancer ranks 6th in the list of most common cancers worldwide and is the third primary source of cancer-related deaths. Asia holds the record for the highest occurrence of HCC. HCC is found three times more frequently in men than in women. The primary risk factors for HCC include chronic viral infections, excessive alcohol intake, steatotic liver disease conditions, as well as genetic and family predispositions. Roughly 40-50% of patients are identified in the late stages of the disease. Recently, there have been significant advancements in the treatment methods for advanced HCC. The selection of treatment for HCC hinges on the stage of the disease and the patient's medical status. Factors such as pre-existing liver conditions, etiology, portal hypertension, and portal vein thrombosis need critical evaluation, monitoring, and appropriate treatment. Depending on the patient and the characteristics of the disease, liver resection, ablation, or transplantation may be deemed potentially curative. For inoperable lesions, arterially directed therapy might be an option, or systemic treatment might be deemed more suitable. In specific cases, the recommendation might extend to external beam radiation therapy. For all individuals, a comprehensive, multidisciplinary approach should be adopted when considering HCC treatment options. The main treatment strategies for advanced HCC patients are typically combination treatments such as immunotherapy and anti-VEGFR inhibitor, or a combination of immunotherapy and immunotherapy where appropriate, as a first-line treatment. Furthermore, some TKIs and immune checkpoint inhibitors may be used as single agents in cases where patients are not fit for the combination therapies. As second-line treatments, some treatment agents have been reported and can be considered.

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<p>Prognostic Significance of Serum Insulin-Like Growth Factor-1 in Hepatocellular Cancer Patients: A Validation Study</p>

Cited by 5 publications

References 33 publications

Insulin-like growth factor 1/Child-Turcotte-Pugh composite score as a predictor of treatment outcomes in patients with advanced hepatocellular carcinoma treated with sorafenib

Insulin-like growth factor 1/Child-Turcotte-Pugh composite score as a predictor of treatment outcomes in patients with advanced hepatocellular carcinoma treated with sorafenib

Serum IGF-1 Scores and Clinical Outcomes in the Phase III IMbrave150 Study of Atezolizumab Plus Bevacizumab versus Sorafenib in Patients with Unresectable Hepatocellular Carcinoma

A Post-International Gastrointestinal Cancers’ Conference (IGICC) Position Statements

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