Value of alpha-fetoprotein response in evaluating the efficacy of sorafenib combined with camrelizumab in treatment of advanced hepatocellular carcinoma
10.3969/j.issn.1001-5256.2023.04.015
- VernacularTitle:甲胎蛋白应答评价索拉非尼联合卡瑞利珠单抗治疗晚期肝细胞癌的效果分析
- Author:
Xing WANG
1
;
Tao ZHANG
1
Author Information
1. Center of Infectious Diseases and Hepatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
- Publication Type:Original Article_Liver Neoplasm
- Keywords:
Carcinoma, Hepatocellular;
alpha-Fetoproteins;
Sorafenib
- From:
Journal of Clinical Hepatology
2023;39(4):843-849
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of alpha-fetoprotein (AFP) response in evaluating the clinical efficacy and safety of sorafenib combined with camrelizumab in the treatment of advanced hepatocellular carcinoma (HCC). Methods Clinical data were collected from 48 patients with advanced HCC who were treated with sorafenib combined with camrelizumab in The First Affiliated Hospital of Xinjiang Medical University from September 2020 to February 2022, and according to the level of AFP response after treatment, they were divided into response group with 32 patients (AFP after 6-8 months of treatment was reduced by more than 20% compared with baseline AFP) and non-response group with 16 patients (AFP after 6-8 months of treatment was reduced by less than 20% compared with baseline AFP). The Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Survival curves were plotted, and univariate and multivariate Cox regression analyses were used to investigate the independent risk factors for overall survival (OS). Progression free survival (PFS) time, OS time, and treatment outcome were compared between the two groups. Results No patient achieved clinical remission in either group. Compared with the non-response group, the response group had significantly higher objective response rate (21.88% vs 0, χ 2 =2.530, P =0.112) and disease control rate (84.38% vs 43.75%, χ 2 =6.668, P =0.010). Compared with the non-response group, the response group had longer PFS time (9.9 months vs 6.8 months) and OS time (13.8 months vs 11.1 months). Early non-response of AFP (hazard ratio [ HR ]=2.624, 95% confidence interval [ CI ]: 1.097-6.277, P =0.030) and extrahepatic metastasis ( HR =0.392, 95% CI : 0.157-0.978, P =0.045) were independently associated with a shorter PFS time. No adverse event leading to drug withdrawal was observed in the study. Conclusion Early AFP response has a high clinical value in predicting the efficacy of sorafenib combined with camrelizumab in the treatment of advanced HCC and the prognosis of such patients.
