TITLE:
Predictive Value of Peripheral Blood Markers in Hepatocellular Carcinoma Patients Treated with Anti-PD-1 in Combination with Targeted Therapy
AUTHORS:
Shaodong Wang, Chengyou Du
KEYWORDS:
Hepatocellular Carcinoma, Immunotherapy, Targeted Therapy, Biomarkers, FLR
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.14 No.4,
April
20,
2023
ABSTRACT: Background: There are currently no recognised biomarkers that identify predictive
groups of benefit in patients with hepatocellular carcinoma receiving
immune-combined targeted therapy, for which we explored the value of peripheral
blood markers as markers of their prognosis. Methods: Patients who
underwent anti-PD-1 combination targeted therapy for hepatocellular carcinoma
from 1 January 2019 to 31 December 2021 at the First Affiliated Hospital of Chongqing
Medical University were retrospectively analysed. The data collected were
analysed by R software. Results: A total of 41 cases were included in
our study. The optimal threshold values of peripheral blood markers were
obtained by plotting ROC curves and grouping patients. Survival analysis of the
grouped patients showed statistically significant differences in survival
between the different groups for Platelet-lymphocyte ratio (PLR, P = 0.0022),
Monocyte-lymphocyte ratio (MLR, P = 0.042), Fibrinogen-Lymphocyte Ratio (FLR, P
= 0.0009), Prognostic nutritional index (PIN, P = 0.0005), and
Fibrinogen-albumin ratio (FAR, P = 0.0144). An ANOVA was performed on the basic
conditions of the patients between the different groups, except for the
statistically significant difference in BCLC stage (P = 0.0128) between the
high MLR and low MLR groups, there was no statistically significant difference
in age, gender, BCLC stage, and hepatitis status between the groups. COX
regression analysis showed that BCLC stage, FAR, FLR and PIN were risk factors
associated with the prognosis of patients receiving targeted combination
immunotherapy for hepatocellular carcinoma, and FLR was an independent risk
factor associated with the prognosis of patients receiving targeted combination
immunotherapy for hepatocellular carcinoma. Conclusions: We found that
peripheral blood markers are promising biomarkers for predicting the prognosis
of patients with hepatocellular carcinoma receiving anti-PD-1 combined with
targeted therapy, and this study identified FLR as an independent risk factor
for the prognosis of patients having advanced hepatocellular carcinoma treated
with anti-PD-1 combined with targeted therapy.