A novel nomogram for predicting the prognosis of hepatocellular carcinoma patients following immune checkpoint inhibitors treatment beyond progression: a single center study based on Chinese population.

IF 6.1 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatobiliary surgery and nutrition Pub Date : 2024-10-01 Epub Date: 2024-05-28 DOI:10.21037/hbsn-23-646
Chao Chen, Xiaoyuan Chu, Hong Liu, Mingzhen Zhou, Zhan Shi, Anfeng Si, Ying Zhao, Xiufeng Liu, Jie Shen, Baorui Liu
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引用次数: 0

Abstract

Background: Hepatocellular carcinoma (HCC) persists as a dominant cause of cancer-related mortality globally, with a notably rapid escalation in mortality rates. The advent of immunotherapy, particularly immune checkpoint inhibitors (ICIs), has ushered in a new era in the management of liver cancer, albeit with unresolved challenges in the context of treatment beyond progression (TBP) and stratified prognosis in diverse populations. This study aimed to develop and validate a novel nomogram model to identify factors that predict the benefit of continued immunotherapy for hepatocellular carcinoma patients following disease progression in clinical practice.

Methods: This study retrospectively analyzed the efficacy of ICIs in TBP, focusing on the Chinese population with advanced liver cancer. A nomogram was constructed based on four independent risk factors identified through Cox multivariate analysis, aiming to predict patient prognosis post-ICI treatment. The model was validated through receiver operating characteristic (ROC) curve analysis and categorized patients into high-, intermediate-, and low-risk groups, with further validation using calibration plots and decision curve analysis (DCA).

Results: The low-risk group demonstrated significantly enhanced overall survival (OS) compared to the high-risk group, with the nomogram predictions aligning closely with actual outcomes for 6- and 9-month OS. The model exhibited commendable predictive accuracy, achieving a C-index exceeding 0.7 in both training and validation datasets. The DCA underscored the clinical utility of the nomogram-based prognostic model, further substantiated by the area under the ROC curve (AUC).

Conclusions: The developed nomogram presents a potentially valuable tool for predicting the prognosis of HCC patients undergoing ICI therapy beyond progression, particularly within the Chinese demographic. However, the study is constrained by its retrospective, single-center nature and necessitates further validation through large-scale, multicenter clinical studies across varied populations.

预测免疫检查点抑制剂治疗后肝细胞癌患者预后的新提名图:一项基于中国人群的单中心研究。
背景:肝细胞癌(HCC)一直是全球癌症相关死亡的主要原因,其死亡率的上升速度尤其快。免疫疗法,尤其是免疫检查点抑制剂(ICIs)的出现开创了肝癌治疗的新纪元,尽管在进展后治疗(TBP)和不同人群的分层预后方面还存在一些尚未解决的难题。本研究旨在开发和验证一种新型提名图模型,以确定在临床实践中预测肝细胞癌患者疾病进展后继续接受免疫治疗的获益因素:本研究以中国晚期肝癌患者为研究对象,回顾性分析了ICIs在TBP中的疗效。根据 Cox 多变量分析确定的四个独立风险因素构建了一个提名图,旨在预测 ICI 治疗后患者的预后。该模型通过接收器操作特征曲线(ROC)分析进行验证,并将患者分为高危、中危和低危组,还通过校准图和决策曲线分析(DCA)进行了进一步验证:结果:与高风险组相比,低风险组的总生存期(OS)明显提高,提名图的预测结果与6个月和9个月OS的实际结果非常吻合。该模型的预测准确性值得称赞,在训练和验证数据集中的C指数都超过了0.7。DCA强调了基于提名图的预后模型的临床实用性,ROC曲线下面积(AUC)进一步证实了这一点:结论:所开发的提名图为预测接受 ICI 治疗的 HCC 患者的预后提供了一个有潜在价值的工具,尤其是在中国人群中。然而,这项研究受限于其回顾性的单中心性质,有必要通过针对不同人群的大规模、多中心临床研究来进一步验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
10.00%
发文量
392
期刊介绍: Hepatobiliary Surgery and Nutrition (HBSN) is a bi-monthly, open-access, peer-reviewed journal (Print ISSN: 2304-3881; Online ISSN: 2304-389X) since December 2012. The journal focuses on hepatopancreatobiliary disease and nutrition, aiming to present new findings and deliver up-to-date, practical information on diagnosis, prevention, and clinical investigations. Areas of interest cover surgical techniques, clinical and basic research, transplantation, therapies, NASH, NAFLD, targeted drugs, gut microbiota, metabolism, cancer immunity, genomics, and nutrition and dietetics. HBSN serves as a valuable resource for professionals seeking insights into diverse aspects of hepatobiliary surgery and nutrition.
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