Kazunari Tanaka, Kunihiko Tsuji, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Toru Ishikawa, Kazuto Tajiri, Hideko Ohama, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Atsushi Naganuma, Hisashi Kosaka, Tomomitsu Matono, Hidekatsu Kuroda, Yutaka Yata, Hiroki Nishikawa, Michitaka Imai, Tomoko Aoki, Hironori Ochi, Yuki Kanayama, Fujimasa Tada, Shinichiro Nakamura, Kazuhiro Nouso, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Akemi Tsutsui, Hironori Tanaka, Hidenao Noritake, Masaki Kaibori, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada, the Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
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They were divided into a training set (<i>n</i> = 280; 13 designated cancer care hospitals) and a validation set (<i>n</i> = 218; 11 universities and their affiliated Japanese hospitals). In the training set, prognostic factors were analysed, leading to the development of the CLEAR score, which was then evaluated on the validation set.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Baseline LDH beyond the upper normal limit (hazard ratio [HR] 1.97, 95% CI 1.48–2.64) and CRP (≥ 0.50 mg/dL) (HR 1.61, 95% CI 1.19–2.00) were identified as independent prognostic factors on multivariate analysis and used in the CLEAR score. In the training set, the median progression-free survival (PFS) times in patients with scores 0, 1 and 2 were 11.1 months, 9.1 months and 3.3 months, respectively (<i>p</i> < 0.001). The median overall survival (OS) times in patients with scores 0, 1 and 2 were not available, 15.3 months and 10.6 months, respectively (<i>p</i> < 0.001). Similar results were obtained in the validation set (median PFS and OS times for scores 0, 1 and 2 = 9.4, 6.9 and 4.3 and 30.6, 20.8 and 8.9 months, respectively, each <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The CLEAR score provides a distinct and simple prediction of the prognosis of HCC patients receiving Atez/Bev therapy.</p>\n </section>\n </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 10","pages":""},"PeriodicalIF":5.2000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Utility of a Prognostic Scoring System Based on LDH and CRP in HCC Patients Receiving Atezolizumab Plus Bevacizumab\",\"authors\":\"Kazunari Tanaka, Kunihiko Tsuji, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Shinya Fukunishi, Toru Ishikawa, Kazuto Tajiri, Hideko Ohama, Hidenori Toyoda, Chikara Ogawa, Takashi Nishimura, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Atsushi Naganuma, Hisashi Kosaka, Tomomitsu Matono, Hidekatsu Kuroda, Yutaka Yata, Hiroki Nishikawa, Michitaka Imai, Tomoko Aoki, Hironori Ochi, Yuki Kanayama, Fujimasa Tada, Shinichiro Nakamura, Kazuhiro Nouso, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Akemi Tsutsui, Hironori Tanaka, Hidenao Noritake, Masaki Kaibori, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada, the Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)\",\"doi\":\"10.1111/liv.70286\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim/Background</h3>\\n \\n <p>This study aimed to validate the CLEAR score, a simple prognostic tool for hepatocellular carcinoma (HCC) patients undergoing atezolizumab plus bevacizumab (Atez/Bev) therapy, based on serum lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Materials/Methods</h3>\\n \\n <p>From 2020 to 2023, 498 Japanese HCC patients receiving Atez/Bev therapy were enrolled. 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引用次数: 0
摘要
目的/背景：本研究旨在验证CLEAR评分，这是一种基于血清乳酸脱氢酶（LDH）和c反应蛋白（CRP）水平的肝细胞癌（HCC）患者接受阿特唑单抗加贝伐单抗（Atez/Bev）治疗的简单预后工具。材料/方法：从2020年到2023年，纳入498例接受Atez/Bev治疗的日本HCC患者。他们被分为训练集（n = 280, 13所指定的癌症护理医院）和验证集（n = 218, 11所大学及其附属的日本医院）。在训练集中，对预后因素进行分析，得出CLEAR评分，然后在验证集中对其进行评估。结果：基线LDH超过正常上限（危险比[HR] 1.97, 95% CI 1.48-2.64）和CRP(≥0.50 mg/dL)（危险比[HR] 1.61, 95% CI 1.19-2.00）被确定为多因素分析的独立预后因素，并用于CLEAR评分。在训练集中，0分、1分和2分患者的中位无进展生存期（PFS）分别为11.1个月、9.1个月和3.3个月(p)。结论：CLEAR评分对接受Atez/Bev治疗的HCC患者的预后提供了清晰、简单的预测。
Clinical Utility of a Prognostic Scoring System Based on LDH and CRP in HCC Patients Receiving Atezolizumab Plus Bevacizumab
Aim/Background
This study aimed to validate the CLEAR score, a simple prognostic tool for hepatocellular carcinoma (HCC) patients undergoing atezolizumab plus bevacizumab (Atez/Bev) therapy, based on serum lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels.
Materials/Methods
From 2020 to 2023, 498 Japanese HCC patients receiving Atez/Bev therapy were enrolled. They were divided into a training set (n = 280; 13 designated cancer care hospitals) and a validation set (n = 218; 11 universities and their affiliated Japanese hospitals). In the training set, prognostic factors were analysed, leading to the development of the CLEAR score, which was then evaluated on the validation set.
Results
Baseline LDH beyond the upper normal limit (hazard ratio [HR] 1.97, 95% CI 1.48–2.64) and CRP (≥ 0.50 mg/dL) (HR 1.61, 95% CI 1.19–2.00) were identified as independent prognostic factors on multivariate analysis and used in the CLEAR score. In the training set, the median progression-free survival (PFS) times in patients with scores 0, 1 and 2 were 11.1 months, 9.1 months and 3.3 months, respectively (p < 0.001). The median overall survival (OS) times in patients with scores 0, 1 and 2 were not available, 15.3 months and 10.6 months, respectively (p < 0.001). Similar results were obtained in the validation set (median PFS and OS times for scores 0, 1 and 2 = 9.4, 6.9 and 4.3 and 30.6, 20.8 and 8.9 months, respectively, each p < 0.001).
Conclusion
The CLEAR score provides a distinct and simple prediction of the prognosis of HCC patients receiving Atez/Bev therapy.
期刊介绍：
Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.
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