Changes in alpha-fetoprotein across the systemic therapy continuum in advanced hepatocellular carcinoma—a real-world, multicenter study

• Published in: Therapeutic advances in medical oncology 2024-01, Vol.16, p.17588359241297085
• Main Authors: Li, Michael, Hannan, Lindsay M., Goyal, Lipika, Bocobo, Andrea G., Parks, Anna L., Bauer, Kelly, Baiev, Islam, Dinicola, Caroline, Gordan, John D., Venook, Alan P., Harris, William P., Bracci, Paige, Kelley, Robin K.
• Format: Article
• Language: English
• Subjects: Expanding the Use of Immune Checkpoint Inhibitors in Hepatocellular Carcinoma: New Advances and Unmet Needs; Hepatocellular carcinoma; Immune checkpoint inhibitors; Liver cancer; α-Fetoprotein
• ISSN: 1758-8359; 1758-8340; 1758-8359
• DOI: 10.1177/17588359241297085

Background: Early changes in alpha-fetoprotein (AFP) are a promising surrogate endpoint for systemic treatment outcomes in hepatocellular carcinoma (HCC). Objectives: We sought to investigate the utility of AFP response across first-line sorafenib (1L SOR) and later-line checkpoint inhibitor (CPI) therapies. Design: We conducted a multicenter, retrospective cohort study of patients with advanced HCC who received 1L SOR and any subsequent CPI. Methods: The primary outcomes were overall survival (OS) and time on treatment (TOT). Pre-treatment AFP and the lowest AFP within 3 months of treatment initiation were used to calculate the percent change in AFP for each treatment. AFP response was defined as an AFP reduction by ⩾20% within 3 months, and AFP progression was defined as an increase in AFP by ⩾20% within 3 months. Patients with baseline AFP