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Tada, Toshifumi; Kumada, Takashi; Hiraoka, Atsushi; Kariyama, Kazuya; Tani, Joji; Hirooka, Masashi; Takaguchi, Koichi; Atsukawa, Masanori; Fukunishi, Shinya; Itobayashi, Ei; Tsuji, Kunihiko; Tajiri, Kazuto; Ochi, Hironori; Ishikawa, Toru; Yasuda, Satoshi; Ogawa, Chikara; Toyoda, Hidenori; Hatanaka, Takeshi; Nishimura, Takashi; Kakizaki, Satoru; Kawata, Kazuhito; Shimada, Noritomo; Tada, Fujimasa; Nouso, Kazuhiro; Tsutsui, Akemi; Ohama, Hideko; Morishita, Asahiro; Nagano, Takuya; Itokawa, Norio; Okubo, Tomomi; Arai, Taeang; Kosaka, Hisashi; Imai, Michitaka; Naganuma, Atsushi; Nakamura, Shinichiro; Koizumi, Yohei; Kaibori, Masaki; Iijima, Hiroko; Hiasa, Yoichi
Cancer medicine (Malden, MA), March 2023, Letnik: 12, Številka: 6Journal Article
Aim Recently, the neo‐Glasgow prognostic score (GPS), a composite biomarker determined by the C‐reactive protein level and albumin–bilirubin grade, was developed to predict outcomes in hepatocellular carcinoma (HCC) patients who undergo hepatic resection. The present research investigated whether the neo‐GPS could predict prognosis in HCC patients treated with atezolizumab plus bevacizumab (Atez/Bev). Methods A total of 421 patients with HCC who were treated with Atez/Bev were investigated. Results Multivariate Cox hazards analysis showed that a GPS of 1 (hazard ratio (HR), 1.711; 95% confidence interval (CI), 1.106–2.646) and a GPS of 2 (HR, 4.643; 95% CI, 2.778–7.762) were independently associated with overall survival. Conversely, multivariate Cox hazards analysis showed that a neo‐GPS of 1 (HR, 3.038; 95% CI, 1.715–5.383) and a neo‐GPS of 2 (HR, 5.312; 95% CI, 2.853–9.890) were also independently associated with overall survival in this cohort. Additionally, cumulative overall survival rates differed significantly by GPS and neo‐GPS (p < 0.001). The neo‐GPS, compared with the GPS, had a lower Akaike information criterion (1207 vs. 1,211, respectively) and a higher c‐index (0.677 vs. 0.652, respectively) regarding to overall survival. In a subgroup analysis of patients considered to have a good prognosis as confirmed using a Child–Pugh score of 5 (p = 0.001), a neutrophil‐to‐lymphocyte ratio <3 (p = 0.001), or an α‐fetoprotein level < 100 ng/mL (p < 0.001), those with a high neo‐GPS (≥1) had a statistically poorer overall survival than those with a low neo‐GPS. Conclusions The neo‐GPS can predict prognosis in advanced unresectable HCC patients treated with Atez/Bev. The neo‐Glasgow prognostic score, based on C‐reactive protein level and albumin‐bilirubin grade, was developed as a new biomarker for hepatocellular carcinoma. High neo‐Glasgow prognostic scores were associated with poor outcomes in patients treated with atezolizumab plus bevacizumab.In comparison with the Glasgow prognostic score, the neo‐Glasgow prognostic score was associated with a lower Akaike information criterion value and higher c‐index for overall survival.
