Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy

• Published in: Journal of hepatocellular carcinoma 2023-01, Vol.10, p.1827-1837
• Main Authors: Luo, Meng-Chao, Wu, Jia-Yi, Wu, Jun-Yi, Lin, Zhong-Tai, Li, Yi-Nan, Zeng, Zhen-Xin, Wei, Shao-Ming, Yan, Mao-Lin
• Format: Article
• Language: English
• Subjects: alpha-fetoprotein; combination therapy; des-gamma-carboxyprothrombin; Original Research; tumor response; unresectable hepatocellular carcinoma
• ISSN: 2253-5969; 2253-5969
• DOI: 10.2147/JHC.S425674

PurposeFew reliable biomarkers for predicting the efficacy of triple therapy (lenvatinib + immune checkpoint inhibitors + transarterial chemoembolization) exist for patients with unresectable hepatocellular carcinoma (uHCC). This study explored the prognostic role of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) levels in patients with uHCC receiving triple therapy. Patients and MethodsThis retrospective study included 93 patients with uHCC who received triple therapy at Fujian Provincial Hospital between August 2020 and November 2022. Depending on the respective baseline levels, the patients were divided into high-AFP and high-DCP groups. An early response was defined as an AFP or DCP concentration >50% less than the baseline concentration after 6 weeks of triple therapy. The primary endpoint was the objective response rate (ORR). The secondary endpoints were progression-free survival (PFS) and overall survival (OS). ResultsAfter 6 weeks of triple therapy, 75.3% (58/77) and 78.9% (60/76) of patients in the high-AFP and high-DCP groups achieved an objective response. Early AFP and DCP responses were positively associated with ORR (high-AFP group: odds ratio [OR]: 13.542; 95% confidence interval [CI]: 3.991-45.950, p