早期甲胎蛋白反应预测免疫检查点抑制剂和肝细胞癌靶向治

StephenW

早期甲胎蛋白反应预测免疫检查点抑制剂和肝细胞癌靶向治疗的预后：荟萃分析的系统评价
田宝文
, 闫伦杰
, 紫牛丁
, 刘慧
, 孟广晓
, 薛俊帅
， 显示所有
2022 年 9 月 6 日收到，2022 年 12 月 6 日接受，接受的作者版本在线发布：2022 年 12 月 7 日，在线发布：2022 年 12 月 12 日

     下载引文 https://doi.org/10.1080/17474124.2022.2156859 CrossMark Logo CrossMark

抽象的
背景

尚未确定甲胎蛋白 (AFP) 反应对靶向治疗或免疫检查点抑制剂 (ICI) 疗效的预后价值。 本荟萃分析的目的是阐明接受靶向治疗或 ICI 的肝细胞癌 (HCC) 患者的 AFP 反应与生存结果之间的关系。
方法

风险比 (HR) 和 95% 置信区间 (CI) 用于评估 AFP 反应与总生存期 (OS)/无进展生存期 (PFS) 之间的关系。
结果

最终纳入研究的26篇文献共3056例HCC患者。 汇总结果显示，在靶向治疗或 ICI 后，AFP 降低的患者预后更好（OS：HR = 0.48，95%CI：0.40-0.56；PFS：HR = 0.39，95%CI：0.33-0.46），而 AFP 升高的患者预后较差（OS：HR = 2.30，95%CI：1.82–2.89；PFS：HR = 2.34，95%CI = 1.69–3.24）。 亚组分析显示，与 AFP 降低 >50% 相比，AFP 降低 >20% 可以更好地预测接受靶向治疗的患者的预后（OS：HR = 0.51，95%CI：0.41–0.62；PFS：HR = 0.39，95 %CI:0.30–0.51) 或 ICIs 治疗（OS:HR = 0.34, 95%CI:0.16–0.71；PFS:HR = 0.22, 95%CI:0.10–0.47），靶向治疗后 8 周可能是合适的 AFP 评估的时间点。
结论

AFP 在 8 周内下降 >20% 可能是早期 AFP 反应的恰当定义，这可能最能预测治疗效果。

StephenW

Early alpha-fetoprotein response predicts prognosis of immune checkpoint inhibitor and targeted therapy for hepatocellular carcinoma: a systematic review with meta-analysis
Bao-Wen Tian
, Lun-Jie Yan
, Zi-Niu Ding
, Hui Liu
, Guang-Xiao Meng
, Jun-Shuai Xue
, show all
Received 06 Sep 2022, Accepted 06 Dec 2022, Accepted author version posted online: 07 Dec 2022, Published online: 12 Dec 2022

    Download citation https://doi.org/10.1080/17474124.2022.2156859 CrossMark Logo CrossMark

ABSTRACT
Background

The prognostic value of alpha-fetoprotein (AFP) response for efficacy of targeted therapy or immune checkpoint inhibitors (ICIs) has not been established. The purpose of this meta-analysis is to elucidate the relationship between AFP response and survival outcomes in hepatocellular carcinoma (HCC) patients who received targeted therapy or ICIs.
Methods

The hazard ratio (HR) with 95% confidence interval (CI) was used to evaluate the relationship between AFP response and overall survival (OS)/progression-free survival (PFS).
Results

Twenty-six articles containing 3056 HCC patients were finally included in the study. The pooled results showed that after targeted therapy or ICIs, patients with decrease in AFP had better prognosis (OS:HR = 0.48, 95%CI:0.40–0.56; PFS:HR = 0.39, 95%CI:0.33–0.46), while patients with increase in AFP had worse prognosis (OS:HR = 2.30, 95%CI:1.82–2.89; PFS:HR = 2.34, 95%CI = 1.69–3.24). Subgroup analysis revealed that compared to AFP decrease >50%, AFP decrease >20% can better predict the prognosis of patients who received targeted therapy (OS:HR = 0.51, 95%CI:0.41–0.62; PFS:HR = 0.39, 95%CI:0.30–0.51) or ICIs treatment (OS:HR = 0.34, 95%CI:0.16–0.71; PFS:HR = 0.22, 95%CI:0.10–0.47), and 8 weeks after targeted therapy may be the appropriate time point for AFP assessment.
Conclusion

AFP decrease >20% within 8 weeks may be the appropriate definition for early AFP response which probably works best in predicting the efficacy of therapy.

StephenW

https://figshare.com/articles/jo ... /files/38519024.pdf