Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma
Immune checkpoint inhibitors (ICI) have been applied to treat advanced stage hepatocellular carcinoma (HCC) and obtain promising effects. However, tumor response to treatment was unpredictable. A predicting biomarker of objective response or disease-control is an unmet need for patient selection. In...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/7/1607 |
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| author | Hao-Chien Hung Jin-Chiao Lee Yu-Chao Wang Chih-Hsien Cheng Tsung-Han Wu Chen-Fang Lee Ting-Jung Wu Hong-Shiue Chou Kun-Ming Chan Wei-Chen Lee |
| author_facet | Hao-Chien Hung Jin-Chiao Lee Yu-Chao Wang Chih-Hsien Cheng Tsung-Han Wu Chen-Fang Lee Ting-Jung Wu Hong-Shiue Chou Kun-Ming Chan Wei-Chen Lee |
| author_sort | Hao-Chien Hung |
| collection | DOAJ |
| description | Immune checkpoint inhibitors (ICI) have been applied to treat advanced stage hepatocellular carcinoma (HCC) and obtain promising effects. However, tumor response to treatment was unpredictable. A predicting biomarker of objective response or disease-control is an unmet need for patient selection. In this study, 45 advanced HCC patients who failed to sorafenib treatment and received nivolumab, 3 mg/kg bi-weekly, were included. Tumor responses to nivolumab treatment were assessed by the modified response evaluation criteria in solid tumors (mRECIST) criteria. Tumor responses were correlated to clinical characteristics to find out response predictors. In this small series, the prevalence of extrahepatic nodal metastasis, distant metastasis, and portal vein thrombus among the patients were 22.2% (<i>n</i> = 10), 48.9% (<i>n</i> = 22), and 42.2% (<i>n</i> = 19), respectively. The pre-treatment tumor size was 7.2 ± 4.2 cm in maximal diameter, and the calculated total tumor volume was 619.0 ± 831.1 cm<sup>3</sup>. Among 45 patients, 3 patients had partial response (PR), 11 had stable disease (SD), and the other 31 had progression of disease. By correlating clinical data to the patients with PR and SD, serum neutrophil-to-lymphocyte ratio (NLR) (hazard ratio (HR) = 2.04) and patient-generated subjective global assessment (PG-SGA) score (HR = 2.30) were the independent factors in multivariate analysis. By receiver operating characteristic curve analysis, pre-treatment NLR ≤ 2.5 and PG-SGA score < 4 were the cutoff points to predict tumor response to ICI treatment. In conclusion, biomarkers to predict tumor response for HCC are still lacking in this costly ICI therapy. In this study, NLR ≤ 2.5 and PG-SGA score < 4 indicated disease-control, and can be applied as biomarkers to select the right patients to receive this costly therapy. |
| first_indexed | 2024-03-10T12:45:57Z |
| format | Article |
| id | doaj.art-d9a6d5bf20da4fccab587d7cedd2ba41 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T12:45:57Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d9a6d5bf20da4fccab587d7cedd2ba412023-11-21T13:32:50ZengMDPI AGCancers2072-66942021-03-01137160710.3390/cancers13071607Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular CarcinomaHao-Chien Hung0Jin-Chiao Lee1Yu-Chao Wang2Chih-Hsien Cheng3Tsung-Han Wu4Chen-Fang Lee5Ting-Jung Wu6Hong-Shiue Chou7Kun-Ming Chan8Wei-Chen Lee9Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanDivision of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 33357, TaiwanImmune checkpoint inhibitors (ICI) have been applied to treat advanced stage hepatocellular carcinoma (HCC) and obtain promising effects. However, tumor response to treatment was unpredictable. A predicting biomarker of objective response or disease-control is an unmet need for patient selection. In this study, 45 advanced HCC patients who failed to sorafenib treatment and received nivolumab, 3 mg/kg bi-weekly, were included. Tumor responses to nivolumab treatment were assessed by the modified response evaluation criteria in solid tumors (mRECIST) criteria. Tumor responses were correlated to clinical characteristics to find out response predictors. In this small series, the prevalence of extrahepatic nodal metastasis, distant metastasis, and portal vein thrombus among the patients were 22.2% (<i>n</i> = 10), 48.9% (<i>n</i> = 22), and 42.2% (<i>n</i> = 19), respectively. The pre-treatment tumor size was 7.2 ± 4.2 cm in maximal diameter, and the calculated total tumor volume was 619.0 ± 831.1 cm<sup>3</sup>. Among 45 patients, 3 patients had partial response (PR), 11 had stable disease (SD), and the other 31 had progression of disease. By correlating clinical data to the patients with PR and SD, serum neutrophil-to-lymphocyte ratio (NLR) (hazard ratio (HR) = 2.04) and patient-generated subjective global assessment (PG-SGA) score (HR = 2.30) were the independent factors in multivariate analysis. By receiver operating characteristic curve analysis, pre-treatment NLR ≤ 2.5 and PG-SGA score < 4 were the cutoff points to predict tumor response to ICI treatment. In conclusion, biomarkers to predict tumor response for HCC are still lacking in this costly ICI therapy. In this study, NLR ≤ 2.5 and PG-SGA score < 4 indicated disease-control, and can be applied as biomarkers to select the right patients to receive this costly therapy.https://www.mdpi.com/2072-6694/13/7/1607NLRhepatocellular carcinomaimmunotherapypatient-generated subjective global assessmentprogression-free survival |
| spellingShingle | Hao-Chien Hung Jin-Chiao Lee Yu-Chao Wang Chih-Hsien Cheng Tsung-Han Wu Chen-Fang Lee Ting-Jung Wu Hong-Shiue Chou Kun-Ming Chan Wei-Chen Lee Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma Cancers NLR hepatocellular carcinoma immunotherapy patient-generated subjective global assessment progression-free survival |
| title | Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma |
| title_full | Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma |
| title_fullStr | Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma |
| title_full_unstemmed | Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma |
| title_short | Response Prediction in Immune Checkpoint Inhibitor Immunotherapy for Advanced Hepatocellular Carcinoma |
| title_sort | response prediction in immune checkpoint inhibitor immunotherapy for advanced hepatocellular carcinoma |
| topic | NLR hepatocellular carcinoma immunotherapy patient-generated subjective global assessment progression-free survival |
| url | https://www.mdpi.com/2072-6694/13/7/1607 |
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