Early alpha‐foetoprotein response associated with treatment efficacy of immune checkpoint inhibitors for advanced hepatocellular carcinoma
Journal
Liver International
Journal Volume
39
Journal Issue
11
Date Issued
2019
Abstract
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background: Post-treatment decline in serum alpha-foetoprotein (AFP) levels has been shown to predict the treatment efficacy of antiangiogenic therapy for advanced hepatocellular carcinoma (HCC). We explored whether a decline in AFP levels was also associated with treatment outcomes of immune checkpoint inhibitors (ICIs) in patients with advanced HCC. Methods: We reviewed all patients who received ICI therapy for advanced HCC. AFP response was evaluated in patients with the pretreatment AFP level of >20 ng/mL. We defined early AFP response as a >20% decline in serum AFP levels within the first 4 weeks of treatment initiation relative to pretreatment levels. We then studied whether early AFP response was associated with treatment outcomes. Results: Sixty patients were enrolled in this study; 43 of them were evaluable for early AFP response. The objective response rate of early AFP responders was significantly higher than that of early AFP nonresponders (73% vs. 14%, P <.001). Early AFP responders, compared with early AFP nonresponders, exhibited significantly longer overall survival (OS) (median, 28.0 vs 11.2 months, P =.048) and progression-free survival (PFS) (median, 15.2 vs 2.7 months, P =.002). After adjusting for other clinicopathological variables and treatments, early AFP response remained an independent predictor for longer OS (hazard ratio [HR] = 0.089, 95% confidence interval [CI] = 0.018-0.441; P =.003) and PFS (HR = 0.128, 95% CI = 0.041-0.399; P <.001). Conclusion: Early AFP response was associated with higher treatment efficacy of ICIs for advanced HCC. Additional validation studies are nonetheless warranted.
Subjects
advanced hepatocellular carcinoma | alpha-fetoprotein | alpha-foetoprotein | biomarker | immune checkpoint inhibitors | immunotherapy
advanced hepatocellular carcinoma; alpha-fetoprotein; alpha-foetoprotein; biomarker; immune checkpoint inhibitors; immunotherapy
SDGs
Other Subjects
alpha fetoprotein; immune checkpoint inhibitor; immunological antineoplastic agent; unclassified drug; alpha fetoprotein; angiogenesis inhibitor; immunological antineoplastic agent; tumor marker; adult; advanced cancer; alpha fetoprotein blood level; Article; cancer immunotherapy; cancer survival; drug efficacy; female; human; liver cell carcinoma; major clinical study; male; middle aged; overall survival; progression free survival; treatment outcome; aged; blood; liver cell carcinoma; liver tumor; metabolism; mortality; survival analysis; Taiwan; urine; Adult; Aged; alpha-Fetoproteins; Angiogenesis Inhibitors; Antineoplastic Agents, Immunological; Biomarkers, Tumor; Carcinoma, Hepatocellular; Female; Humans; Liver Neoplasms; Male; Middle Aged; Survival Analysis; Taiwan; Treatment Outcome
Publisher
Wiley
Type
journal article