New score developed to predict outcome in liver cancer patients receiving immunotherapy

There are still no established biomarkers to predict the success of immunotherapy in patients with liver cancer. In a multicenter study led by Matthias Pinter of the Division of Gastroenterology and Hepatology at the Medical University of Vienna, a score based on simple laboratory parameters has now been developed to predict outcome in patients with d ‘liver cancer receiving immunotherapy. The results were published in the prestigious Journal of Hepatology.

With the aim of providing personalized medicine (also known as precision medicine), the Liver Cancer Study Group (HCC) Vienna, led by Matthias Pinter at the Division of Gastroenterology and Hepatology of the Department of Medicine III of MedUni Vienna and Vienna General Hospital, is primarily concerned with identifying groups of patients who might respond particularly well to certain forms of treatment.

The recent large-scale international retrospective study developed a score based on the two routine laboratory parameters, alpha-fetoprotein (AFP; tumor marker) and C-reactive protein (CRP; inflammatory marker) correlated with the results. in patients with liver cancer treated with immunotherapy.

If both parameters were raised above a certain level, patients had significantly shorter survival and a lower likelihood of achieving radiological control of the disease with immunotherapy. Both parameters, AFP and CRP, can influence the tumor immune environment to promote tumor growth and potentially make immunotherapy less effective. “

Bernhard Scheiner, first author

The results were validated in an independent cohort. A total of 14 European centers participated in this study. “Because the score is based on simple laboratory parameters, it is objective and widely available. In the future, the score could help in the selection of patients for clinical trials and support decision making in clinical practice, ”says Matthias Pinter.

Immunotherapy for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver and is found mainly in people with chronic liver disease. In most cases, HCC is not diagnosed until it has reached an advanced stage, where surgical or loco-ablative procedures are no longer possible, and systemic drug therapies are mainly used. Recently, the first immunotherapy-based regimen was established for HCC, representing the new standard of care in drug therapy for the vast majority of patients with advanced HCC. It is not yet clear which patients with HCC benefit the most from immunotherapy.

Source:

Vienna Medical University

Journal reference:

Scheiner, B., et al. (2021) Prognosis of patients with hepatocellular carcinoma treated with immunotherapy – development and validation of the CRAFITY score. Journal of Hepatology. doi.org/10.1016/j.jhep.2021.09.035.


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