Journal of Hepatocellular Carcinoma最新文献

{"title":"Refining Intra-Arterial Therapy Selection for Large Hepatocellular Carcinoma: A Deep Learning Approach Based on Covariate Interaction Analysis.","authors":"Chao An, Lei Li, Yang Luo, Mengxuan Zuo, Wendao Liu, Chengzhi Li, Peihong Wu","doi":"10.2147/JHC.S532116","DOIUrl":"https://doi.org/10.2147/JHC.S532116","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a major global health burden, with most patients presenting at advanced stages, limiting treatment options to intra-arterial therapy (IAT) such as transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC). However, optimizing IAT selection for large HCC remains challenging due to tumor heterogeneity and varying patient responses.</p><p><strong>Aim: </strong>To develop and validate a deep learning (DL) model for guidance of decision-making between TACE and HAIC for unresectable HCC.</p><p><strong>Methods: </strong>We conducted a retrospective, multi-center study involving 900 patients with large HCC treated with IATs. The DEep Learning for Interaction and Covariate Analysis in Intra-arterial Therapy SElection (DELICAITE) model integrates deep convolutional neural networks (DCNN) with covariate interaction analysis. The model was trained on dual-modal clinical and imaging data to predict treatment response and was validated using prospective and independent external validation cohorts.</p><p><strong>Results: </strong>The DELICAITE model demonstrated superior discriminative ability and accuracy in predicting progressive disease (PD) in both internal and external test sets, with AUCs of 0.756, 0.664, and 0.701, respectively. Patients classified by the model into the \"Maintain\" group showed significantly longer overall survival (OS) compared to the \"Alter\" group (11.3 months vs 8.1 months, <i>P</i> < 0.001). The model's performance was further supported by its ability to stratify patients into subgroups most likely to benefit from TACE or HAIC.</p><p><strong>Conclusion: </strong>The DELICAITE model provides a precise and innovative approach to refine IAT schemes for large HCC, offering clinicians a reliable tool to select the most suitable treatment option and potentially improve patient survival outcomes.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1393-1405"},"PeriodicalIF":4.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Hepatic Artery Infusion Chemotherapy Combined with Donafenib and Camrelizumab in the Treatment of Patients with Unresectable Hepatocellular Carcinoma: A Retrospective, Single-Arm Study.","authors":"Chenrui Wu, Zixuan Fu, Long Pan, Jiachu Li, Yin Zhou, Ruirui Sun, Yang Gou, Yaowu Zhao, Zhouyan Wang, Yuhao Qiu, Ping Huang","doi":"10.2147/JHC.S525454","DOIUrl":"10.2147/JHC.S525454","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of hepatic artery infusion chemotherapy with oxaliplatin, fluorouracil, and leucovorin (FOLFOX-HAIC) combined with donafenib and camrelizumab in patients with unresectable hepatocellular carcinoma (uHCC).</p><p><strong>Patients and methods: </strong>This retrospective study analyzed clinical data from 49 uHCC patients treated with FOLFOX-HAIC, donafenib tablets, and camrelizumab at the First Affiliated Hospital of Chongqing Medical University between November 1, 2021, and November 30, 2024. The primary endpoint was the objective response rate (ORR), assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and modified RECIST (mRECIST). Secondary endpoints included surgical conversion rate, disease control rate (DCR), progression-free survival (PFS), overall survival (OS), duration of response (DOR), and safety.</p><p><strong>Results: </strong>The median follow-up duration was 20.3 months. Patients had a mean age of 55.9 years and a mean tumor diameter of 9.9 cm, with 25 patients (51%) presenting with extrahepatic metastasis. According to RECIST v1.1, the ORR was 57.1%, and the DCR was 79.6%. Under mRECIST criteria, the ORR increased to 59.2%, while the DCR remained at 79.6%. The median PFS was 12.1 months, and the median OS was 26.0 months. Twelve patients (24.5%) achieved successful conversion, with five patients (10.2%) undergoing surgery achieving R0 resections. Two patients (4.1%) achieved a pathological complete response (pCR). All patients experienced treatment-related adverse events (TRAEs), with Hypoalbuminemia (87.8%) and Hand-foot skin reaction (79.6%) being the most common. Grade 3 or higher TRAEs were observed in 61.2% of patients.</p><p><strong>Conclusion: </strong>For patients with uHCC, the combination therapy of FOLFOX-HAIC with donafenib and camrelizumab demonstrates favorable efficacy and manageable adverse events.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1353-1367"},"PeriodicalIF":4.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silencing NEDD4L Effectively Inhibits the Malignant Behaviors of Hepatocellular Carcinoma.","authors":"Junze Dai, Tong Zhu, Jun Wan, Ruibin Liu, Yuxuan Song, Dingye Zhang, Xin Wang, Huiyu Zhang, Wenxin Li, Jie Lin, Xudong Zhu, Yefu Liu","doi":"10.2147/JHC.S511466","DOIUrl":"10.2147/JHC.S511466","url":null,"abstract":"<p><strong>Background: </strong>NEDD4L, an E3 ubiquitin ligase, has served a pivotal function in the malignant progression of different cancers. However, research focusing on its involvement in hepatocellular carcinoma (HCC) remains relatively scarce.</p><p><strong>Methods: </strong>This investigation examined NEDD4L's expression, survival implications, and regulatory mechanisms of NEDD4L in HCC using RNA-seq and microarray data across multiple databases. Additionally, we investigated the impact of NEDD4L expression on malignant biological behaviors of HCC by in vitro functional assays including Edu, CCK-8, Transwell, and wound healing assay. Finally, single-cell sequencing data from HCC patients were employed to further investigate and validate NEDD4L expression patterns across various stages of HCC and its immune functional states.</p><p><strong>Results: </strong>NEDD4L was identified as one of the most markedly differentially expressed genes linked to ubiquitination in HCC and was noted to be an independent prognostic marker for overall survival, with higher expression levels correlating with poorer outcomes. Knockdown of NEDD4L significantly inhibited cell proliferation, migration, and scratch healing ability in HCC. Moreover, NEDD4L expression was closely linked to the regulation of the cell cycle and DNA damage repair, potentially driving abnormal cell cycle progression and HCC development by mediating the degradation of inhibitory cell cycle checkpoints or their upstream transcription factors via ubiquitination. Single-cell sequencing analysis revealed that NEDD4L was notably enriched in cancer stem cell populations across different HCC developmental stages and immune states, with subgroups exhibiting high NEDD4L expression sharing substantial co-expressed genes with stem cell subpopulations. Furthermore, an analysis of NEDD4L's relationships with immune infiltration indicated that NEDD4L could facilitate immune evasion in HCC by downregulating stimulatory immune checkpoints and immune cell infiltration, a phenomenon also observed in other types of tumors.</p><p><strong>Conclusion: </strong>These findings indicate that NEDD4L is upregulated in HCC and strongly associated with unfavorable patient outcomes, pointing to its prospective utility as a biomarker for HCC. Furthermore, silencing NEDD4L could effectively inhibit the malignant behaviors of HCC. Given its dual role in regulating both cell cycle and immune checkpoints, NEDD4L represents a promising therapeutic target for HCC. Targeting NEDD4L could potentially enhance the efficacy of cyclin-dependent kinase inhibitors and immune checkpoint inhibitors.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1369-1391"},"PeriodicalIF":4.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Team Management of Hepatocellular Carcinoma in the MENA Region: Current Practices, Challenges, and Gaps.","authors":"Mohamed El-Kassas, Rofida Khalifa, Khalid M AlNaamani, Hend Shousha, Yusuf Yilmaz, Faisal M Sanai, Maen Almattooq, Asma Labidi, Maisam W I Akroush, Nabil Debzi, Mohamed Omar Abdelmalek, Nermeen Sherif Abdeen, Ali Tumi, Mohamed Elbadry, Amr El Fouly, Eman Marwan, Jassim Al Suwaidi, Abdel-Naser Elzouki, Khalid A Alswat","doi":"10.2147/JHC.S528470","DOIUrl":"10.2147/JHC.S528470","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with a high disease burden in the Middle East and North Africa (MENA) region. Multidisciplinary teams (MDTs) are essential for optimizing HCC management; however, their implementation and impact may vary across healthcare settings. This study evaluates the structure, decision-making processes, and challenges faced by MDTs in HCC treatment centers across the MENA region.</p><p><strong>Patients and methods: </strong>This cross-sectional, multicenter study surveyed representatives from 53 HCC treatment centers across 38 cities in 11 MENA countries. A structured questionnaire was electronically distributed to assess MDT composition, meeting frequency, decision-making processes, adherence to clinical guidelines, patient management pathways, and challenges in HCC treatment.</p><p><strong>Results: </strong>Among the surveyed centers, 84.9% (n=45) reported having an established MDT. The most common specialties involved in MDT composition were hepatology (100%), interventional radiology (97.8%), medical oncology (91.1%), and hepatobiliary surgery (80%). Barcelona Clinic Liver Cancer staging was used in 95.6% of centers. Despite acknowledging MDT benefits, major challenges were documented by participants, including resource limitations (13.2%), financial constraints (13.2%), patient nonadherence (9.4%), and limited access to advanced technology (11.3%). Telemedicine was underutilized (9.4% of centers), and only 15.1% experienced participation in clinical trials.</p><p><strong>Conclusion: </strong>Our result highlights the pivotal role of MDTs in HCC management in the MENA region, demonstrating adherence to evidence-based guidelines and exposing critical gaps in resource availability, technology integration, and patient-centered decision-making. Strengthening MDTs through enhanced resource allocation, digital health adoption, and increased clinical trial participation is essential to improving HCC outcomes in the region.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1315-1335"},"PeriodicalIF":4.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hsa_circ_0007991 Promotes Immune Evasion in Hepatocellular Carcinoma via Regulation of the miR-505-3p/CANX Axis.","authors":"LingLing Wang, Li Liang, Jing Qian, Chao Yu, Yu Shi, XiaoDi Yan, Xiang Chen","doi":"10.2147/JHC.S513120","DOIUrl":"10.2147/JHC.S513120","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the expression and functional role of hsa_circ_0007991 in hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>RNA expression data of HCC and corresponding non-tumor liver tissues were obtained from the GEO database, and differential expression analysis was conducted to identify significantly dysregulated circRNAs. A total of 68 clinical samples from HCC patients were collected, and hsa_circ_0007991 level was quantified using RT-qPCR. Gain- and loss-of-function experiments were performed on HCC cells, followed by assessments of cellular proliferation, apoptosis, and immune evasion using CCK-8, EdU incorporation assays, flow cytometry, and ELISA. The role of hsa_circ_0007991 as a ceRNA was further validated using dual-luciferase reporter assay, RNA immunoprecipitation, and nuclear-cytoplasmic fractionation.</p><p><strong>Results: </strong>A significant upregulation of hsa_circ_0007991 was observed in HCC tissues, with increased levels correlating with advanced TNM stages. hsa_circ_0007991 silencing significantly suppressed HCC cell proliferation and immune evasion, while promoting apoptosis, whereas hsa_circ_0007991 overexpression yielded the opposite effects. The function of hsa_circ_0007991 involves binding to miR-505-3p, which modulates the expression of calnexin (CANX), influencing the biological behaviors of HCC cells. Rescue experiments validated the essential function of the hsa_circ_0007991/miR-505-3p/CANX pathway in HCC.</p><p><strong>Conclusion: </strong>hsa_circ_0007991 is upregulated in HCC and closely associated with tumor proliferation and immune evasion by regulating the miR-505-3p/CANX axis.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1337-1351"},"PeriodicalIF":4.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyper-Relapse Disease is a Special Pattern of Relapse of Hepatocellular Carcinoma After Curative Hepatectomy: A Retrospective Cohort Study.","authors":"Zi-Liang Yang, Yi-Xiang Gan, Jing-Xuan Xu, Yu-Hao Tang, Li-Ying Ouyang, Lu-Nan Qi, Li Xu","doi":"10.2147/JHC.S507437","DOIUrl":"10.2147/JHC.S507437","url":null,"abstract":"<p><strong>Background: </strong>While hepatectomy is the major curative treatment of hepatocellular carcinoma (HCC), high relapsing rates were observed. Of note, quite a few cases of tumor relapses were characterized by very quick appearance and disseminated lesions. This study aims to identify a special pattern of tumor relapse and to evaluate the prognostic significance of it for HCC patients after curative hepatectomy.</p><p><strong>Methods: </strong>Medical records of HCC patients who underwent curative hepatectomy from January 1st 2018 to December 31st 2019 at Sun Yat-sen University Cancer Center (SYSUCC) were reviewed. Patients (n = 217) identified with tumor relapse during follow-up were included for analyses. Hyper-relapse disease (HRD) is defined as tumor relapse within 6 months from surgery, multiple intrahepatic lesions, as well as macrovascular invasion and/or extrahepatic metastasis. Kaplan-Meier method and Cox regression model were used to analyze overall survival (OS). Risk factors for HRD were explored using logistic regression analysis. External validation was performed using data from another center (n = 270).</p><p><strong>Results: </strong>In SYSUCC cohort, 66 (30%) encountered HRD, 118 (54%) had non-HRD early recurrence (ER), and 33 (16%) had late recurrence (LR). The HRD group had shorter OS than the non-HRD ER and the LR groups (P < 0.001). COX analysis identified HRD and PIVKA-II >1000 mAU/mL as risk factors of poorer OS. Intriguingly, local therapy (HR [95% CI]: 0.528 [0.290-0.961]) was associated with better OS in contrast to systemic therapies (HR [95% CI]: 1.120 [0.596-2.107]) after tumor relapse (p = 0.001). Logistic regression analysis identified microvascular invasion and HBV infection as independent factors associated with HRD. The worse outcome of the HRD group was validated in the external cohort, compared with the non-HRD ER group (P < 0.001).</p><p><strong>Conclusion: </strong>HRD is a special pattern of HCC relapse with poor prognosis after curative hepatectomy. Appropriate local therapy might improve patient survival after tumor relapse.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1301-1314"},"PeriodicalIF":4.2,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating CEUS Imaging Features and LI-RADS Classification for Postoperative Early Recurrence Prediction in Solitary Hepatocellular Carcinoma: A Machine Learning-Based Prognostic Approach.","authors":"Li Liang, Jinshu Pang, Bulin Zhang, Qiao Que, Ruizhi Gao, Yuquan Wu, Jinbo Peng, Wei Zhang, Xiumei Bai, Rong Wen, Yun He, Hong Yang","doi":"10.2147/JHC.S530848","DOIUrl":"10.2147/JHC.S530848","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a machine learning (ML) model for predicting early postoperative recurrence in hepatocellular carcinoma (HCC) patients by integrating contrast-enhanced ultrasound (CEUS) features with Liver Imaging Reporting and Data System (LI-RADS) classification.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on data from 279 patients who underwent surgical resection for HCC. CEUS-derived features, including the LI-RADS classification, were integrated with clinical and pathological variables to construct predictive models. Patients were randomly assigned to training (n = 196) and validation (n = 83) cohorts in a 7:3 ratio. Feature selection was performed using univariate Cox regression (p ≤ 0.05), and four ML algorithms-Random Survival Forest (RSF), Gradient Boosting Machine (GBM), CoxBoost, and XGBoost-were applied to develop recurrence prediction models. Model performance was evaluated using the concordance index (C-index), area under the curve (AUC), calibration curves, decision curve analysis (DCA), and Kaplan-Meier (KM) survival analysis.</p><p><strong>Results: </strong>Five significant features identified by univariate Cox regression were included in model development: microvascular invasion (MVI), tumor size, LI-RADS classification, tumor necrosis, and arterial enhancement patterns. Among the four ML algorithms, GBM achieved the best overall performance, with the following results. The C-index for 1-year and 2-year recurrence prediction was 0.802 and 0.735 in the training cohort, and 0.804 and 0.710 in the validation cohort, respectively. The corresponding AUCs were 0.820 and 0.764 in the training cohort, and 0.817 and 0.716 in the validation cohort. Feature importance analysis identified LI-RADS classification, MVI, and tumor size as the top three prognostic indicators, while KM survival analysis confirmed the model's ability to stratify patients into distinct risk groups (training cohort: <i>p</i> < 0.001; validation cohort: <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>The GBM-based ML model integrating CEUS imaging features and LI-RADS classification demonstrates potential for predicting early postoperative recurrence of HCC, which may assist in guiding follow-up strategies.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1287-1300"},"PeriodicalIF":4.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining Hepatic Arterial Interventional Therapies with Lenvatinib and Programmed Cell Death-1 Inhibitors for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Single-Center, Real-World Study.","authors":"Xuehan Shen, Tianyin Shao, Jun Yu, Zhiwei Zhang","doi":"10.2147/JHC.S530550","DOIUrl":"10.2147/JHC.S530550","url":null,"abstract":"<p><strong>Background and purpose: </strong>The survival of hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) was poor. This study aimed to investigate the efficacy and safety of hepatic arterial interventional therapies (HAIT) combined with lenvatinib and programmed cell death-1 (PD-1) inhibitors for HCC patients with PVTT.</p><p><strong>Methods: </strong>In this retrospective study, HCC patients with PVTT treated with HAIT combined with lenvatinib and PD-1 inhibitors (H-L-P group) or lenvatinib plus PD-1 inhibitors (L-P group) between June 2020 and December 2023 were analyzed. Overall survival (OS), progression-free survival (PFS), and tumor response were evaluated to assess the efficacy, while treatment-related adverse events (TRAEs) were evaluated to assess the safety. Propensity score matching (PSM) was applied to balance the baseline differences.</p><p><strong>Results: </strong>In this study, 208 HCC patients with PVTT were enrolled, including 120 patients in H-L-P group and 88 patients in L-P group. After PSM, there were 74 patients per group, the H-L-P group showed significantly better median OS (19 months vs 14 months, <i>p</i> < 0.001) and median PFS (10 months vs 4 months, <i>p</i> < 0.001) than L-P group; higher objective response rate (ORR) (37.8% vs 16.2%, <i>p</i> < 0.001) and disease control rate (DCR) (78.4% vs 47.3%, <i>p</i> < 0.001) were observed in the H-L-P group. All TRAEs were controlled, and the three most prevalent TRAEs in the H-L-P group were elevated aspartate aminotransferase (AST), elevated alanine aminotransferase (ALT), and vomiting.</p><p><strong>Conclusion: </strong>Combining HAIT with lenvatinib and PD-1 inhibitors is a safe and promising treatment pattern for HCC patients with PVTT.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1267-1278"},"PeriodicalIF":4.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Multicentre Real-Life Study Evaluating the Efficacy of Atezolizumab Combined with Bevacizumab for the Treatment of Metastatic Hepatocellular Carcinoma: HIREAL Study.","authors":"Jean-Baptiste Barbe-Richaud, Fabien Moinard-Butot, Stéphanie Husson-Wetzel, Marion Bolliet, Pascale Chiappa, Christine Belletier, Mathieu Ribeiro, Elodie Poprawa, Cécile Bigot, Armand Abergel, Meher Ben Abdelghani","doi":"10.2147/JHC.S521130","DOIUrl":"10.2147/JHC.S521130","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is the most common hepatic malignancy and is one of the most prevalent cancers worldwide. The prognosis of late-stage HCC remains poor. The ImBrave 150 trial successfully demonstrated that overall survival (OS) and progression-free survival (PFS) was improved among patients treated with atezolizumab combined with bevacizumab (AB) compared with patients treated with sorafenib. Real-world data are essential to assess the safety and efficacy of new therapies in HCC, given patients' fragility and the heterogeneity of underlying liver diseases.</p><p><strong>Objective: </strong>The primary objective of this study was to evaluate the OS and PFS of patients with locally advanced or metastatic HCC treated with atezolizumab combined with bevacizumab. The secondary objective was to conduct subgroup analyses to further examine how the effects of the combination treatment differ based on Child‒Pugh scores, prior local treatment, and alpha-fetoprotein (AFP) levels.</p><p><strong>Methods: </strong>We conducted a multicentric retrospective study. All patients with confirmed locally advanced or metastatic HCC treated with atezolizumab combined with bevacizumab between January 2021 and December 2023 were included.</p><p><strong>Results: </strong>Seventy patients were included. A total of 76% presented with cirrhosis, among which 85% had Child‒Pugh class A cirrhosis. The cirrhosis cases were mostly nonviral (85.7%). The median OS was 19 months (95% CI: 15-NA), and the median PFS was 6.7 months (95% CI: 4.7-14.2 months). The secondary analysis revealed a statistically significant difference in OS between patients with Child‒Pugh class A cirrhosis and those with Child‒Pugh class B cirrhosis, with median OS durations of 18.9 months (95% CI: 16.9-NA) and 6.0 months (95% CI: 1.5-NA), respectively (p = 0.03). However, the retrospective design and the lack of a control group represent important limitations.</p><p><strong>Conclusion: </strong>Our real-life study yielded OS and PFS durations similar to those reported in the ImBrave 150 trial.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1279-1286"},"PeriodicalIF":4.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Prediction of a Rare and Highly Aggressive Subtype of Hepatocellular Carcinoma Based on Multimodal Imaging and Clinical Indicators.","authors":"Keke Chen, Yuli Zhu, Han Liu, Minying Deng, Wentao Kong, Wenping Wang","doi":"10.2147/JHC.S533963","DOIUrl":"10.2147/JHC.S533963","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a reliable preoperative non-invasive diagnostic model for dual-phenotype hepatocellular carcinoma (DPHCC) by integrating multimodal imaging and clinical indicators, thereby facilitating clinical decision-making.</p><p><strong>Patients and methods: </strong>222 pathologically confirmed patients (61 with DPHCC, 161 with non-DPHCC) were retrospectively enrolled in this study and randomly assigned to training and validation cohorts in an 8:2 ratio. Serological and multimodal imaging characteristics were analyzed. Univariate and multivariate logistic regression analyses identified independent DPHCC predictors and built a nomogram. Model performance and clinical utility were assessed by receiver operating characteristic (ROC) and decision curve analysis (DCA) curve respectively. The calibration curve was used to verify the model. Recurrence-free survival (RFS) was assessed using Kaplan-Meier and Log rank tests.</p><p><strong>Results: </strong>In multivariate analysis, age (OR=0.91; P < 0.001), LDH (OR=1.03; P=0.002), PT (OR=0.14; P < 0.001), AFP (OR=4.04; P=0.019), Adler grade (OR=0.17; P=0.037), non-enhancing area (OR=8.30; P=0.004), arterial phase hyperenhancement (OR=0.12; P=0.015) and enhancing capsule (OR=0.32; P=0.04) were independent predictors of DPHCC. The nomogram achieved a robust predictive performance with C-index (0.92 vs 0.87) and accuracy (0.87 vs 0.86) in the training and validation cohorts. In addition, the calibration curve and DCA also showed good model performance. DPHCC patients had significantly lower RFS than non-DPHCC patients (P = 0.037).</p><p><strong>Conclusion: </strong>A nomogram was established for non-invasive prediction of DPHCC risk utilizing multimodal imaging combined with clinical indicators to help achieve personalized treatment.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1253-1266"},"PeriodicalIF":4.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}