Journal of Hepatocellular Carcinoma最新文献

{"title":"Tolerability and Effectiveness of Regorafenib Treatment in Patients with Unresectable Hepatocellular Carcinoma: Real-World Data from the United States.","authors":"Richard S Finn, Renuka Iyer, Richard S Kalman, Neehar D Parikh, Roniel Cabrera, Svetlana Babajanyan, Ahmed O Kaseb","doi":"10.2147/JHC.S459983","DOIUrl":"10.2147/JHC.S459983","url":null,"abstract":"<p><strong>Introduction: </strong>While several systemic therapies are available for unresectable hepatocellular carcinoma (uHCC), there is a lack of granular real-world evidence to support the efficacy and safety of these therapies. The REFINE study evaluated safety and effectiveness of regorafenib in a global population under real-world practice conditions. This sub-analysis describes the safety and effectiveness of regorafenib among the United States (US) subset of patients in the REFINE study relative to patients in the non-US subset.</p><p><strong>Materials and methods: </strong>REFINE was an international, prospective, multicenter observational study. Eligible patients were those with uHCC for whom a decision to treat with regorafenib had already been made. The primary study endpoint was the frequency of documented treatment-emergent adverse events (TEAEs). Additional endpoints included overall survival and progression-free survival. Groups were compared descriptively.</p><p><strong>Results: </strong>Of 1005 patients, 65 were from the US and 940 were from other countries. 91% of patients in the US subset (n=59) and 92% in the non-US subset (n=862) experienced ≥1 TEAE. Common adverse events (AEs) included gastrointestinal disorders, fatigue, and hand-foot skin reaction. Median overall survival for patients in the US subset was 11.4 months (interquartile range [IQR]: 4.7-25.4) and 13.2 months (IQR: 5.8-26.3) in the non-US subset. Median progression-free survival was 3.4 months (IQR: 2.4-6.1) for patients in the US subset and 3.9 months (IQR: 2.2-8.5) in the non-US subset.</p><p><strong>Conclusion: </strong>Regorafenib was associated with similar safety and effectiveness outcomes for patients in the US and non-US subsets of the REFINE study. Differences in the incidence of certain AEs may be due to differences in treatment management between study sites or baseline disease status. These findings are consistent with the phase 3 RESORCE trial and corroborate the safety and effectiveness of regorafenib as a subsequent-line treatment in US patients with uHCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"231-246"},"PeriodicalIF":4.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399301","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":"Simultaneous Liver Venous Deprivation Following Hepatic Arterial Chemoembolization Before Major Hepatectomy for Hepatocellular Carcinoma: A New Methods to Achieve Hypertrophy Liver Remnant.","authors":"Shenyu Zhang, Ruipeng Song, Changlong Hou, Huanzhang Yao, Jun Xu, Hangcheng Zhou, Shaopeng Li, Wei Cai, Yipeng Fei, Fanzheng Meng, Dalong Yin, Jiabei Wang, Shugeng Zhang, Yao Liu, Jizhou Wang, Lianxin Liu","doi":"10.2147/JHC.S495304","DOIUrl":"10.2147/JHC.S495304","url":null,"abstract":"<p><strong>Purpose: </strong>Liver venous deprivation (LVD; simultaneous portal vein embolization and hepatic vein embolization) has been the latest surgical strategy for rapid future liver remnant (FLR) hypertrophy. The aim of this study was to assess the feasibility, safety, and efficacy of simultaneous LVD following hepatic arterial chemoembolization (TACE-LVD) before major hepatectomy for hepatocellular carcinoma (HCC).</p><p><strong>Patients and methods: </strong>A retrospective analysis of the outcomes of 23 HCC patients who underwent TACE-LVD at our center between October 2019 and October 2023 was conducted. An assessment of postoperative complications, FLR volume, liver function, and tumor response was performed.</p><p><strong>Results: </strong>All patients successfully underwent TACE-LVD. No other serious complications occurred except in 1 patient who underwent puncture drainage due to excessive pleural effusion. Following TACE-LVD, transaminase levels peak two days before rapidly decreasing and return to preoperative levels within one week. The ratio of FLR to standardized liver volume increased from 35.9% (interquartile range [IQR], 8.6) to 46.4% (IQR, 8.2), with a mean degree of hypertrophy and kinetic growth rate of 13.2% (IQR, 5.4) and 4.4% (IQR, 1.8) per week, respectively. At the first assessment after TACE-LVD, most patients exhibited sufficient FLR for hepatectomy, except for 4 patients with cirrhosis. The modified response evaluation criteria for solid tumor assessment revealed a disease control rate of 95.7%, with only 1 patient (Barcelona Clinic Liver Cancer stage C) developing intrahepatic disease progression.</p><p><strong>Conclusion: </strong>TACE-LVD seems to be a feasible, safe, and effective strategy for rapid FLR hypertrophy. Moreover, TACE-LVD may be a therapeutic choice if insufficient FLR hypertrophy precludes resection. This strategy warrants further exploration.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"219-229"},"PeriodicalIF":4.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391096","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":"Long-Term Analysis of Recurrence Beyond Milan Criteria Following Ablation of Solitary Early-Stage Hepatocellular Carcinoma ≤3 cm in Potentially Transplantable Patients: A Over 10-Year Survival Study.","authors":"Shuanggang Chen, Han Qi, Hongtong Tan, Fei Cao, Lin Xie, Tao Huang, Ying Wu, Chunyong Wen, Yujia Wang, Lujun Shen, Weijun Fan","doi":"10.2147/JHC.S505979","DOIUrl":"10.2147/JHC.S505979","url":null,"abstract":"<p><strong>Background: </strong>Salvage liver transplantation is promising for hepatocellular carcinoma(HCC) recurrence post-ablation but is significantly affected by recurrence beyond Milan Criteria (RBM).</p><p><strong>Materials and methods: </strong>A retrospective cohort study of potentially transplantable HCC patients undergoing ablation between 2007 and 2017 assessed median time to recurrence beyond Milan Criteria(TRBM) via Kaplan-Meier curves and predictive capacity of recurrence and RBM for overall survival(OS) via Receiver Operating Characteristic Curves, and identified independent risk factors for TRBM and RBM via Cox and binary logistic regression models.</p><p><strong>Results: </strong>We enrolled 191 potentially transplantable patients with early-stage HBV-related HCC ≤3 cm who underwent ablation. During a median follow-up of 7.64 years, HCC recurrence occurred in 126 patients(65.9%), with RBM 86 patients(45.0%). The median TRBM was 10.54 years. Cumulative survival rates without RBM at 3, 5, 8, 10, and 13 years were 77.3%, 65.9%, 56.5%, 51.0%, and 37.6%, respectively. Multivariable analysis identified older age, C-reactive protein(CRP)≥1.81 mg/L, and platelet(PLT)≤80×10⁹/L as independent risk factors for TRBM. Also, cirrhosis, CRP≥1.81 mg/L and PLT≤80×10⁹/L were identified as independent risk factors of the occurrence of RBM. Elevated Platelet-CRP Score(PCS), integrating CRP and PLT, correlated significantly with an increased incidence of RBM and a more aggressive phenotype, characterized by vascular invasion or metastatic dissemination (<i>P</i><0.05). Notably, RBM was a superior predictive indicator for OS compared to recurrence (P<0.05).</p><p><strong>Conclusion: </strong>When using ablation as a bridge to liver transplantation for solitary HBV-related early HCC (≤3 cm), it is crucial first to identify key preoperative features, including high CRP, low PLT, cirrhosis, and older age.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"205-218"},"PeriodicalIF":4.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382605","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":"The Clinical Characteristics, Patterns of Recurrence, and Long-Term Survival Outcomes of Dual-Phenotype Hepatocellular Carcinoma After Curative Liver Resection.","authors":"Zi-Chen Yu, Zheng-Kang Fang, Yang Yu, Si-Yu Liu, Kai-Di Wang, Zhe-Jin Shi, Li-Ming Jin, Xiao-Kun Huang, Yi Lu, Guo-Liang Shen, Jun-Wei Liu, Dong-Sheng Huang, Cheng-Wu Zhang, Lei Liang","doi":"10.2147/JHC.S493094","DOIUrl":"10.2147/JHC.S493094","url":null,"abstract":"<p><strong>Background & aims: </strong>Dual-phenotype hepatocellular carcinoma (DPHCC) is discernible from classical HCC (CHCC) in its morphology and is characterized by the co-expression of both CHCC and cholangiocyte markers. This study aimed to clarify the difference between DPHCC and CHCC after surgery.</p><p><strong>Methods: </strong>Patients with HCC after surgery were collected. The clinical characteristics, patterns of recurrence, and survival outcomes of patients with DPHCC and CHCC were compared. Multivariate analyses were used to determine the independent risk factors that influence the prognosis of patients.</p><p><strong>Results: </strong>Patients with DPHCC (n = 141) account for 26% of the total patients (n = 541). Compared to patients with CHCC, patients with DPHCC are significantly associated with incomplete capsules, microvascular invasion, and poor differentiation (all P < 0.05). Compared to patients with CHCC, the 5-year overall survival (OS) (56% vs 43%) and recurrence-free survival (RFS) (35% vs 28%) are lower in patients with DPHCC. Meanwhile, among patients with tumor recurrence after surgery, patients with DPHCC have a higher proportion of advanced-stage tumors, and extrahepatic metastasis (all P < 0.05). Moreover, multivariate analysis showed that DPHCC is an independent risk factor for both OS (HR 1.399, 95% CI 1.061-1.845, P = 0.017) and RFS (HR 1.313, 95% CI 1.033-1.669, P = 0.026).</p><p><strong>Conclusion: </strong>DPHCC, an aggressive HCC subtype with poor differentiation and high invasiveness, shows inferior RFS and OS post-liver resection compared to CHCC. Clinicians' recognition and addressing of its unique challenges can improve DPHCC patients' prognosis and QoL.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"183-192"},"PeriodicalIF":4.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123058","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":"TRACE Model: Predicting Treatment Response to Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma.","authors":"Weilang Wang, Qi Zhang, Ying Cui, Shuhang Zhang, Binrong Li, Tianyi Xia, Yang Song, Shuwei Zhou, Feng Ye, Wenbo Xiao, Kun Cao, Yuan Chi, Jinrong Qu, Guofeng Zhou, Zhao Chen, Teng Zhang, Xunjun Chen, Shenghong Ju, Yuan-Cheng Wang","doi":"10.2147/JHC.S490226","DOIUrl":"10.2147/JHC.S490226","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a predictive model for predicting six-month outcome by integrating pretreatment MRI features and one-month treatment response after TACE.</p><p><strong>Methods: </strong>A total of 108 patients with 160 hCCs from a single-arm, multicenter clinical trial (NCT03113955) were analyzed and served as the training cohort. An external multicenter dataset (ChiCTR2100046020) consisting of 63 patients with 99 hCCs served as the test dataset. Radiomics model was constructed based on the selected features from pretreatment MR images. Univariate and multivariate logistic regression analysis of clinical and radiological factors were used to identify the independent predictors for the 6-month treatment response. A combined model was further constructed by incorporating one-month treatment response, selected clinical and radiological factors and radiomics signature.</p><p><strong>Results: </strong>Among all the clinical and radiological features, only corona enhancement and one-month treatment response were selected. The combined model, named TRACE model (Treatment response at 1 month, RAdiomics and Corona Enhancement), with AUCs of 0.91 (training cohort) and 0.84 (test cohort). The TRACE model demonstrated a significantly higher AUC than the radiomics model (<i>P</i> = 0.001). High-risk and low-risk groups stratified by using the TRACE model also exhibited significant differences in overall survival (OS) (<i>P</i> < 0.001). In contrast, none of the published scoring systems, including ART, SNACOR or ABCR score, demonstrated significant differences between the risk groups in OS prediction.</p><p><strong>Conclusion: </strong>The TRACE model exhibited favorable predictive capability for six-month TACE response, and holds potential as a marker for long-term survival outcomes.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"193-203"},"PeriodicalIF":4.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080404","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":"Clinical Outcomes of Hepatic Arterial Infusion Chemotherapy Plus Lenvatinib and Tislelizumab for Treating Hepatocellular Carcinoma and Type IV Portal Vein Tumor Thrombus.","authors":"Xiaowei Li, Kunkun Cao, Zhigang Fu, Xiaoxia Chen, Jiaming Zhong, Li Liu, Ning Ding, Xiaoli Zhang, Zengqiang Qu, Lijun Zhu, Jian Zhai","doi":"10.2147/JHC.S488734","DOIUrl":"10.2147/JHC.S488734","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the activity and toxicity of hepatic arterial infusion chemotherapy (HAIC)+tislelizumab+lenvatinib (HAIC+tisle+len) in hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) type IV (Vp4 hCC) in a real-world context.</p><p><strong>Methods: </strong>Fifty-five patients, with Vp4 hCC receiving HAIC+tisle+len therapy from April 2021 to December 2022, were analyzed retrospectively. Data on patient characteristics, adverse events (AEs), treatment, and survival were collected. Outcomes were disease control rate (DCR), overall response rate (ORR), overall survival (OS), progression-free survival (PFS), and treatment-related AEs (TRAEs).</p><p><strong>Results: </strong>As of December 20, 2023, the median follow-up was 17.5 months (95% confidence interval [CI]: 14.7-22.5). The ORR was 52.7% (3 complete response [CR], 26 partial response [PR]) as per RECIST v1.1 and 65.5% (12 CR, 24 PR) as per mRECIST. The DCR was 94.5% using both RECIST v1.1 and mRECIST. The median PFS and the median OS were 8.0 months (95% CI: 6.2-12.3) and 16.7 months (95% CI: 12.0-not reached), respectively. Additionally, PFS was independently predicted only by the best tumor response. In patients with the best tumor response (PR or CR), the median PFS was 11.7 months (95% CI: 8.02-not reached) by mRECIST and 15.4 months (95% CI: 7.39-not reached) by RECIST v1.1. Hypertension (14.5%), decreased albumin levels (10.9%) and anorexia (9.1%) were the most frequently observed grade 3-4 TRAEs.</p><p><strong>Conclusion: </strong>HAIC+tisle+len regimen demonstrated a promising efficacy and favorable safety for patients with HCC and Vp4, providing valuable real-world evidence to complement the trial data for Vp4 hCC.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"169-182"},"PeriodicalIF":4.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065889","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":"Design and Mechanism Study of 6c, a Novel Artesunate Derivatives, for Anti-Hepatocellular Carcinoma.","authors":"Shang-Shang Xiong","doi":"10.2147/JHC.S490445","DOIUrl":"https://doi.org/10.2147/JHC.S490445","url":null,"abstract":"<p><strong>Objective: </strong>Artesunate can inhibit the proliferation of various tumor cells and has practical value in developing anti-tumor drugs. However, its biological activity against hepatocellular carcinoma is weak. The efficacy of its anti-tumor effect needs to be improved.</p><p><strong>Methods: </strong>11 compounds of three types were designed and synthesized. Their antitumor activity was detected by MTT assay in vitro and subcutaneous xenograft model in vivo. Then, DCFH-DA probe detection and NAC intervention experiments were used to detect ROS levels. The ferroptosis inhibitor (Liproxstatin-1) was used to study the effect of compound 6c in inducing ferroptosis. Western blot was used to observe the expression of apoptosis-related proteins. The ability of 6c to induce apoptosis was detected by Annexin V-FITC/PI double staining and Hoechst 33342 staining experiment. The effect of 6c on cycle arrest was detected by flow cytometry. Molecular simulations of several hybrids with vascular endothelial growth factor receptor 2 (<i>VEGFR-2</i>) and Transferrin receptor protein 1 (<i>TFR1</i>) were performed using MOE molecular docking software.</p><p><strong>Results: </strong>A series of new artemisinin-4-(4-substituted phenoxy) pyridine derivatives were synthesized and their anticancer activities were tested in three lines of hepatocellular carcinoma (HCC) cells. Among the hybrid hits with anticancer activity, a representative 6c compound increased the reactive oxygen species (ROS) level in hepatocellular carcinoma cells and activated mitochondrial apoptosis and ferroptosis, leading to cell cycle arrest at G2/M phase. Molecular docking shows the binding of 6c compound to oncogenic vascular endothelial growth factor receptor 2 (<i>VEGFR-2</i>) and Transferrin receptor protein 1 (<i>TFR1</i>) that are overexpressed in malignant epithelial tumors.</p><p><strong>Conclusion: </strong>Taken together, our identification of the promising compound 6c may hold developmental potential for therapy of hepatocellular carcinoma.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"149-167"},"PeriodicalIF":4.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065848","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":"The Prognostic Value of Peripheral Blood Inflammatory Markers in Hepatocellular Carcinoma Treated with Lenvatinib Combined with PD-1 Inhibitors.","authors":"Yujing Xin, Ning Liu, Gang Peng, Xiaoyu Huang, Xiaojing Cao, Xiang Zhou","doi":"10.2147/JHC.S486910","DOIUrl":"10.2147/JHC.S486910","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prognostic value of inflammatory indexes based on peripheral blood cells in unresectable hepatocellular carcinoma (HCC) patients treated with Lenvatinib combined with PD-1 inhibitors.</p><p><strong>Methods: </strong>This study retrospectively collected baseline inflammatory indexes from HCC patients received Lenvatinib and PD-1 inhibitor-based combination therapy at the Cancer Hospital of the Chinese Academy of Medical Sciences between October 2018 and October 2021. The optimal threshold values for inflammatory indexes determined using X-tile. The factors related to treatment response and survival outcomes were analyzed through logistic regression and Cox regression, respectively. A novel preoperative prognostic nomogram was constructed based on inflammatory indexes, and the predictive efficacy of the nomogram and BCLC staging was compared by the area under the ROC curve.</p><p><strong>Results: </strong>156 eligible patients with unresectable HCC were included, with median OS and PFS of 23.8 and 11.5 months, respectively, and ORR of 48.7%. The baseline SIRI was an independent factor of treatment response, with a significantly higher ORR for patients with a SIRI <0.8 than for patients with a SIRI ≥0.8 (59.7% vs 41.5%, P=0.03). SIRI and PNI were independent prognostic factors of PFS, and SIRI was an independent prognostic factor of OS. The AUC value of nomogram based on baseline SIRI, PNI, and tumor distribution in predicting the 6-,12- and 18-month PFS of patients was significantly higher than that of traditional BCLC stage, and its prediction performance was substantially better than that of BCLC stage system (C-index, 0.730 vs 0.535).</p><p><strong>Conclusion: </strong>The baseline SIRI could be used as a potential non-invasive biomarker to predict the efficacy and survival benefit of immune combination therapy for HCC. The nomogram based on inflammation indexes could achieve better prediction performance and help clinicians to identify high-risk patients and formulate treatment plans.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"135-147"},"PeriodicalIF":4.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059264","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":"Impact of Timing the Combination of Radiotherapy and PD-1 Inhibitors on Outcomes in Patients with Hepatocellular Carcinoma.","authors":"Liting Zhong, Weiwei Peng, Jingyuan Sun, Yongyi Luo, Hailong Sheng, Yi Wu, Tonggang Zhou, Chaoming Zhou, Chuanhui Cao","doi":"10.2147/JHC.S480691","DOIUrl":"10.2147/JHC.S480691","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal timing for combining radiotherapy with immunotherapy in patients with hepatocellular carcinoma (HCC) remains uncertain and affects treatment efficacy and patient outcomes. This study aimed to evaluate and compare the efficacy and treatment-related adverse events (TRAEs) of synchronously administered radiotherapy and programmed cell death protein (PD)-1 inhibitors and sequential administration in patients with HCC.</p><p><strong>Patients and methods: </strong>We retrospectively enrolled 67 patients with HCC who were undergoing liver radiotherapy and PD-1 inhibitor therapy at two medical centers between July 2017 and April 2023. Additionally, we created an experimental tumor model using 6-week-old female mice to validate our findings.</p><p><strong>Results: </strong>In the concurrent group, the median overall survival was indefinite; however, it was 13 months in the sequential group (95% confidence interval [CI] 6.7-19.3 months, <i>P</i>=0.010). The median progression-free survival was significantly longer in the concurrent group (12 months, 95% CI 9.5-14.5 months) than in the sequential group (7 months, 95% CI 1.3-12.7 months; <i>P</i>=0.043). Grade 3/4 TRAEs occurred in 30.4% (concurrent) and 28.6% (sequential) of patients without any treatment-related deaths. In the mouse model, synchronous treatment significantly inhibited tumor growth compared to sequential treatment (293.4±45.18 mm³ versus 602.7±41.68 mm³; <i>P</i>=0.001). Flow cytometry revealed an increased Tregs/CD3⁺ T cell ratio and a decreased CD8⁺/Treg cell ratio post-radiotherapy, suggesting an immunosuppressive tumor microenvironment.</p><p><strong>Conclusion: </strong>Synchronous treatment demonstrated superior efficacy in treating HCC compared to sequential treatment, with manageable adverse events. The rapid increase in Tregs after radiotherapy may contribute to the reduced efficacy of sequential radiotherapy plus PD-1 inhibitors.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"123-134"},"PeriodicalIF":4.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052776","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":"A Machine Learning Model for Predicting Prognosis in HCC Patients With Diabetes After TACE.","authors":"Linxia Wu, Lei Chen, Lijie Zhang, Yiming Liu, Die Ouyang, Wenlong Wu, Yu Lei, Ping Han, Huangxuan Zhao, Chuansheng Zheng","doi":"10.2147/JHC.S496481","DOIUrl":"10.2147/JHC.S496481","url":null,"abstract":"<p><strong>Purpose: </strong>Type II diabetes mellitus (T2DM) has been found to increase the mortality of patients with hepatocellular carcinoma (HCC). Therefore, this study aimed to establish and validate a machine learning-based explainable prediction model of prognosis in patients with HCC and T2DM undergoing transarterial chemoembolization (TACE).</p><p><strong>Patients and methods: </strong>The prediction model was developed using data from the derivation cohort comprising patients from three medical centers, followed by external validation utilizing patient data extracted from another center. Further, five predictive models were employed to establish prognosis models for 1-, 2-, and 3-year survival, respectively. Prediction performance was assessed by the receiver operating characteristic (ROC), calibration, and decision curve analysis curves. Lastly, the SHapley Additive exPlanations (SHAP) method was used to interpret the final ML model.</p><p><strong>Results: </strong>A total of 636 patients were included. Thirteen variables were selected for the model development. The final random survival forest (RSF) model exhibited excellent performance in the internal validation cohort, with areas under the ROC curve (AUCs) of 0.824, 0.853, and 0.810 in the 1-, 2-, and 3-year survival groups, respectively. This model also demonstrated remarkable discrimination in the external validation cohort, achieving AUCs of 0.862, 0.815, and 0.798 in the 1-, 2-, and 3-year survival groups, respectively. SHAP summary plots were also created to interpret the RSF model.</p><p><strong>Conclusion: </strong>An RSF model with good predictive performance was developed by incorporating simple parameters. This prognostic prediction model may assist physicians in early clinical intervention and improve prognosis outcomes in patients with HCC and comorbid T2DM after TACE.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"77-91"},"PeriodicalIF":4.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046987","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}