The alpha-fetoprotein response and its prognostic evaluation value for patients with advanced hepatocellular carcinoma treated with karelizumab in combination with sorafenib

Abstract

Abstract: Objective To analysis the alpha-fetoprotein (AFP) response and its prognostic evaluation value of patients with advanced hepatocellular carcinoma (HCC) treated with karelizumab in combination with sorafenib. Methods Sixty patients with intermediate and advanced HCC treated with karelizumab combined with sorafenib who were admitted between April 2019 and April 2021 were categorized into 35 cases in the responding group and 25 cases in the non-responding group according to whether the patients responded to the treatment after 8 months of treatment. The clinicopathologic characteristics and tumor regression of the two groups were compared. Kaplan-Meier survival analysis was used to assess the survival in both groups. To analyze the risk factors affecting the prognosis of patients with middle and advanced HCC using multifactorial Cox regression. Results The hemoglobin level in the responder group was (138.2±23.6) g/L, which was higher than that in the non-responder group [(122.5±21.2) g/L, P<0.05]; the levels of AFP and total bilirubin after treatment in the responder group were (172.3±21.5) ng/mL and (12.3±2.1) μmol/L, respectively, which were lower than that of (468.9± 71.2) ng/mL, (21.2±4.1) μmol/L in the non-responder group [P<0.05]; the rates of early response to AFP, disease remission, and disease control in the responder group were 91.4%, 82.9%, and 37.1%, respectively, which were superior to those of 28.0%, 60.0%, and 12.0% in the mortality group [P<0.05], respectively; As of March 2021, the progression-free survival was 9 months in the responder group and 6 months in the nonresponder group, and overall survival was 13 months in the responder group and 11 months in the nonresponder group, with a total of 20 deaths, 8 in the responder group and 12 in the nonresponder group; The survival rate in the responder group was superior to that in the nonresponder group. The results of multifactorial Cox regression analysis showed that an early response of AFP was an independent risk factor affecting the prognosis of patients with intermediate and advanced HCC (OR=3.511, P<0.05). Conclusion The efficacy of karelizumab combined with sorafenib in the treatment of intermediate and advanced HCC is remarkable, and the early response of AFP has a good application value in evaluating the prognosis of patients.

Key words: Karelizumab, Sorafenib, Intermediate to advanced hepatocellular carcinoma, Alpha-fetoprotein, Response changes, Prognosis

ZHANG Yun-jiang, LIANG Liang, ZHANG Dong-cheng. The alpha-fetoprotein response and its prognostic evaluation value for patients with advanced hepatocellular carcinoma treated with karelizumab in combination with sorafenib[J]. Chinese Hepatolgy, 2024, 29(7): 784-787.

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