Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy
Meng-Chao Luo,1,2,* Jia-Yi Wu,1,3,* Jun-Yi Wu,1,3 Zhong-Tai Lin,1,2 Yi-Nan Li,3 Zhen-Xin Zeng,3 Shao-Ming Wei,1,2 Mao-Lin Yan1,3 1Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, People’s Republic of China; 2Department of General Surgery...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-10-01
|
| Series: | Journal of Hepatocellular Carcinoma |
| Subjects: | |
| Online Access: | https://www.dovepress.com/early-tumor-marker-response-predicts-treatment-outcomes-in-patients-wi-peer-reviewed-fulltext-article-JHC |
| _version_ | 1797658952463286272 |
|---|---|
| author | Luo MC Wu JY Wu JY Lin ZT Li YN Zeng ZX Wei SM Yan ML |
| author_facet | Luo MC Wu JY Wu JY Lin ZT Li YN Zeng ZX Wei SM Yan ML |
| author_sort | Luo MC |
| collection | DOAJ |
| description | Meng-Chao Luo,1,2,* Jia-Yi Wu,1,3,* Jun-Yi Wu,1,3 Zhong-Tai Lin,1,2 Yi-Nan Li,3 Zhen-Xin Zeng,3 Shao-Ming Wei,1,2 Mao-Lin Yan1,3 1Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, People’s Republic of China; 2Department of General Surgery, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, People’s Republic of China; 3Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mao-Lin Yan, The Shengli Clinical Medical College of Fujian Medical University, Dongjie Road 134, Fuzhou, Fujian Province, 350001, People’s Republic of China, Tel +86 591-88217130, Fax +86 591-87557768, Email yanmaolin74@163.com Shao-Ming Wei, Department of General Surgery, Fujian Provincial Hospital, Jinrong South Road 516, Fuzhou, Fujian Province, 350001, People’s Republic of China, Tel +86 591-88618707, Fax +86 591-88618900, Email 67468424@qq.comPurpose: Few reliable biomarkers for predicting the efficacy of triple therapy (lenvatinib + immune checkpoint inhibitors + transarterial chemoembolization) exist for patients with unresectable hepatocellular carcinoma (uHCC). This study explored the prognostic role of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) levels in patients with uHCC receiving triple therapy.Patients and Methods: This retrospective study included 93 patients with uHCC who received triple therapy at Fujian Provincial Hospital between August 2020 and November 2022. Depending on the respective baseline levels, the patients were divided into high-AFP and high-DCP groups. An early response was defined as an AFP or DCP concentration > 50% less than the baseline concentration after 6 weeks of triple therapy. The primary endpoint was the objective response rate (ORR). The secondary endpoints were progression-free survival (PFS) and overall survival (OS).Results: After 6 weeks of triple therapy, 75.3% (58/77) and 78.9% (60/76) of patients in the high-AFP and high-DCP groups achieved an objective response. Early AFP and DCP responses were positively associated with ORR (high-AFP group: odds ratio [OR]: 13.542; 95% confidence interval [CI]: 3.991– 45.950, p< 0.001; high-DCP group: OR: 17.853; 95% CI: 4.478– 71.179, p< 0.001). In the high-AFP group, the 6-month, 12-month, and 18-month PFS and OS rates were higher in the AFP responders than those in the non-responders (PFS: 66.4%, 59.6%, 48.2% vs 42.3%, 19.3%, 0%, p< 0.001; OS: 94.5%, 90.4%, 77.3% vs 75.6%, 66.2%, 49.6%, p=0.006). In the high-DCP group, the 6-month, 12-month, and 18-month PFS and OS rates were higher in the DCP responders than those in the non-responders (PFS: 67.4%, 57.7%, 39.0% vs 38.9%, 8.1%, 0%, p< 0.001; OS: 94.7%, 94.7%, 83.3% vs 77.0%, 53.9%, 36.0%, p< 0.001).Conclusion: After 6 weeks of triple therapy, an AFP or DCP reduction of > 50% predicts better treatment outcomes in uHCC patients.Keywords: unresectable hepatocellular carcinoma, alpha-fetoprotein, des-gamma-carboxyprothrombin, combination therapy, tumor response |
| first_indexed | 2024-03-11T18:06:52Z |
| format | Article |
| id | doaj.art-1c8fa37b1c8840bca2bc8eafc1a00765 |
| institution | Directory Open Access Journal |
| issn | 2253-5969 |
| language | English |
| last_indexed | 2024-03-11T18:06:52Z |
| publishDate | 2023-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Hepatocellular Carcinoma |
| spelling | doaj.art-1c8fa37b1c8840bca2bc8eafc1a007652023-10-17T02:44:54ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692023-10-01Volume 101827183787320Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization TherapyLuo MCWu JYWu JYLin ZTLi YNZeng ZXWei SMYan MLMeng-Chao Luo,1,2,* Jia-Yi Wu,1,3,* Jun-Yi Wu,1,3 Zhong-Tai Lin,1,2 Yi-Nan Li,3 Zhen-Xin Zeng,3 Shao-Ming Wei,1,2 Mao-Lin Yan1,3 1Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian Province, 350001, People’s Republic of China; 2Department of General Surgery, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, People’s Republic of China; 3Department of Hepatobiliary Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mao-Lin Yan, The Shengli Clinical Medical College of Fujian Medical University, Dongjie Road 134, Fuzhou, Fujian Province, 350001, People’s Republic of China, Tel +86 591-88217130, Fax +86 591-87557768, Email yanmaolin74@163.com Shao-Ming Wei, Department of General Surgery, Fujian Provincial Hospital, Jinrong South Road 516, Fuzhou, Fujian Province, 350001, People’s Republic of China, Tel +86 591-88618707, Fax +86 591-88618900, Email 67468424@qq.comPurpose: Few reliable biomarkers for predicting the efficacy of triple therapy (lenvatinib + immune checkpoint inhibitors + transarterial chemoembolization) exist for patients with unresectable hepatocellular carcinoma (uHCC). This study explored the prognostic role of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) levels in patients with uHCC receiving triple therapy.Patients and Methods: This retrospective study included 93 patients with uHCC who received triple therapy at Fujian Provincial Hospital between August 2020 and November 2022. Depending on the respective baseline levels, the patients were divided into high-AFP and high-DCP groups. An early response was defined as an AFP or DCP concentration > 50% less than the baseline concentration after 6 weeks of triple therapy. The primary endpoint was the objective response rate (ORR). The secondary endpoints were progression-free survival (PFS) and overall survival (OS).Results: After 6 weeks of triple therapy, 75.3% (58/77) and 78.9% (60/76) of patients in the high-AFP and high-DCP groups achieved an objective response. Early AFP and DCP responses were positively associated with ORR (high-AFP group: odds ratio [OR]: 13.542; 95% confidence interval [CI]: 3.991– 45.950, p< 0.001; high-DCP group: OR: 17.853; 95% CI: 4.478– 71.179, p< 0.001). In the high-AFP group, the 6-month, 12-month, and 18-month PFS and OS rates were higher in the AFP responders than those in the non-responders (PFS: 66.4%, 59.6%, 48.2% vs 42.3%, 19.3%, 0%, p< 0.001; OS: 94.5%, 90.4%, 77.3% vs 75.6%, 66.2%, 49.6%, p=0.006). In the high-DCP group, the 6-month, 12-month, and 18-month PFS and OS rates were higher in the DCP responders than those in the non-responders (PFS: 67.4%, 57.7%, 39.0% vs 38.9%, 8.1%, 0%, p< 0.001; OS: 94.7%, 94.7%, 83.3% vs 77.0%, 53.9%, 36.0%, p< 0.001).Conclusion: After 6 weeks of triple therapy, an AFP or DCP reduction of > 50% predicts better treatment outcomes in uHCC patients.Keywords: unresectable hepatocellular carcinoma, alpha-fetoprotein, des-gamma-carboxyprothrombin, combination therapy, tumor responsehttps://www.dovepress.com/early-tumor-marker-response-predicts-treatment-outcomes-in-patients-wi-peer-reviewed-fulltext-article-JHCunresectable hepatocellular carcinomaalpha-fetoproteindes-gamma-carboxyprothrombincombination therapytumor response |
| spellingShingle | Luo MC Wu JY Wu JY Lin ZT Li YN Zeng ZX Wei SM Yan ML Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy Journal of Hepatocellular Carcinoma unresectable hepatocellular carcinoma alpha-fetoprotein des-gamma-carboxyprothrombin combination therapy tumor response |
| title | Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy |
| title_full | Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy |
| title_fullStr | Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy |
| title_full_unstemmed | Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy |
| title_short | Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy |
| title_sort | early tumor marker response predicts treatment outcomes in patients with unresectable hepatocellular carcinoma receiving combined lenvatinib immune checkpoint inhibitors and transcatheter arterial chemoembolization therapy |
| topic | unresectable hepatocellular carcinoma alpha-fetoprotein des-gamma-carboxyprothrombin combination therapy tumor response |
| url | https://www.dovepress.com/early-tumor-marker-response-predicts-treatment-outcomes-in-patients-wi-peer-reviewed-fulltext-article-JHC |
| work_keys_str_mv | AT luomc earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy AT wujy earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy AT wujy earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy AT linzt earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy AT liyn earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy AT zengzx earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy AT weism earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy AT yanml earlytumormarkerresponsepredictstreatmentoutcomesinpatientswithunresectablehepatocellularcarcinomareceivingcombinedlenvatinibimmunecheckpointinhibitorsandtranscatheterarterialchemoembolizationtherapy |