Predicting Survival Outcomes in Patients with Hepatocellular Carcinoma Receiving Lenvatinib by Using the Up7-ALBI Score.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver Cancer Pub Date : 2025-04-29 DOI:10.1159/000546185

Chien-Hung Lu, Wei-Yu Kao, Chih-Horng Wu, Wei-Yi Ting, Chia-Hsun Lu, Kai-I Chuang, Cheng-Fu Ni, Yao-Yu Hsieh, Ming-Shun Wu, Chien-Wei Su, San-Chi Chen

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引用次数: 0

Abstract

Introduction: Lenvatinib effectively manages unresectable hepatocellular carcinoma (HCC). Current prognostic models do not integrate tumor burden with liver function. By combining the Up-to-7 criteria and the albumin-bilirubin (ALBI) grade, we developed the Up7-ALBI score, a novel scoring system for predicting survival outcomes in patients with unresectable HCC receiving lenvatinib.

Methods: This multicenter, retrospective study analyzed 205 patients with unresectable HCC. Tumor burden and liver function were assessed using the up-to-7 criteria and the ALBI grade, respectively. Cox proportional-hazards models evaluated their impact on survival. The Up7-ALBI score was developed to categorize patients into distinct prognostic groups. Its prognostic value was validated in a cohort of HCC patients receiving immunotherapy.

Results: The overall response rate (assessed as per the Response Evaluation Criteria in Solid Tumors [RECIST] 1.1 criteria) was 13.2%. This rate was significantly higher for patients without metastases (18.6%) and those with a radiologic tumor burden within the up-to-7 criteria (22.7%). The median progression-free survival and overall survival (OS) were 7.3 and 12.2 months, respectively. Exceeding the up-to-7 criteria (hazard ratio [HR]: 1.61; 95% confidence interval [CI]: 1.00-2.57) and an ALBI grade of 2 or 3 (HR: 1.62; 95% CI: 1.06-2.47) emerged as independent risk factors of OS. A novel Up7-ALBI score stratified patients into low-, intermediate-, and high-risk groups for survival (30.8 vs. 14.2 vs. 9.3 months; p < 0.01). A validation cohort of 58 HCC patients with immunotherapy showed the consistent prognostic value of Up7-ALBI score. The Akaike information criterion value of the Cox proportional-hazards model for BCLC stage, ALBI grade, and Up7-ALBI score was 1,203, 1,174, and 1,170, respectively.

Conclusion: The Up7-ALBI score, incorporating tumor burden and liver function, effectively stratified survival outcomes in HCC patients treated with lenvatinib. Further validation in larger cohorts and across different systemic therapies is required to confirm its broad clinical applicability.

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使用Up7-ALBI评分预测接受Lenvatinib的肝细胞癌患者的生存结局

Lenvatinib有效治疗不可切除的肝细胞癌（HCC）。目前的预后模型没有将肿瘤负荷与肝功能结合起来。通过结合up -7标准和白蛋白-胆红素（ALBI）分级，我们开发了Up7-ALBI评分，这是一种新的评分系统，用于预测接受lenvatinib治疗的不可切除HCC患者的生存结果。方法：本多中心回顾性研究分析了205例不可切除HCC患者。肿瘤负荷和肝功能分别采用-7级标准和ALBI分级进行评估。Cox比例风险模型评估了它们对生存的影响。Up7-ALBI评分用于将患者分为不同的预后组。在接受免疫治疗的HCC患者队列中验证了其预后价值。结果：总有效率（根据实体瘤应答评价标准[RECIST] 1.1标准评估）为13.2%。在没有转移的患者（18.6%）和放射学上肿瘤负担在7级以内的患者（22.7%）中，这一比例明显更高。中位无进展生存期和总生存期（OS）分别为7.3和12.2个月。超过7级标准(风险比[HR]: 1.61；95%可信区间[CI]: 1.00-2.57)， ALBI分级为2或3 (HR: 1.62；95% CI: 1.06-2.47)成为OS的独立危险因素。一项新的Up7-ALBI评分将患者分为低、中、高风险组(30.8个月vs 14.2个月vs 9.3个月；P < 0.01)。58例接受免疫治疗的HCC患者的验证队列显示Up7-ALBI评分具有一致的预后价值。BCLC分期、ALBI分级和Up7-ALBI评分的Cox比例风险模型的Akaike信息标准值分别为1203、1174和1170。结论：结合肿瘤负荷和肝功能的Up7-ALBI评分可以有效地分层lenvatinib治疗的HCC患者的生存结果。需要在更大的队列和不同的全身疗法中进行进一步的验证，以确认其广泛的临床适用性。

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

Liver Cancer Medicine-Oncology

CiteScore

20.80

自引率

7.20%

发文量

审稿时长

16 weeks

期刊介绍： Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.