Early alpha-fetoprotein response predicts prognosis of immune checkpoint inhibitor and targeted therapy for hepatocellular carcinoma: a systematic review with meta-analysis.
Expert Rev Gastroenterol Hepatol
; 17(1): 73-83, 2023 Jan.
Article
em En
| MEDLINE
| ID: mdl-36476076
ABSTRACT
BACKGROUND:
The prognostic value of alpha-fetoprotein (AFP) response for efficacy of targeted therapy or immune checkpoint inhibitors (ICIs) has not been established. The purpose of this meta-analysis is to elucidate the relationship between AFP response and survival outcomes in hepatocellular carcinoma (HCC) patients who received targeted therapy or ICIs.METHODS:
The hazard ratio (HR) with 95% confidence interval (CI) was used to evaluate the relationship between AFP response and overall survival (OS)/progression-free survival (PFS).RESULTS:
Twenty-six articles containing 3056 HCC patients were finally included in the study. The pooled results showed that after targeted therapy or ICIs, patients with decrease in AFP had better prognosis (OSHR = 0.48, 95%CI0.40-0.56; PFSHR = 0.39, 95%CI0.33-0.46), while patients with increase in AFP had worse prognosis (OSHR = 2.30, 95%CI1.82-2.89; PFSHR = 2.34, 95%CI = 1.69-3.24). Subgroup analysis revealed that compared to AFP decrease >50%, AFP decrease >20% can better predict the prognosis of patients who received targeted therapy (OSHR = 0.51, 95%CI0.41-0.62; PFSHR = 0.39, 95%CI0.30-0.51) or ICIs treatment (OSHR = 0.34, 95%CI0.16-0.71; PFSHR = 0.22, 95%CI0.10-0.47), and 8 weeks after targeted therapy may be the appropriate time point for AFP assessment.CONCLUSION:
AFP decrease >20% within 8 weeks may be the appropriate definition for early AFP response which probably works best in predicting the efficacy of therapy. REGISTRATION The review was not registered.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Alfa-Fetoproteínas
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Carcinoma Hepatocelular
/
Inibidores de Checkpoint Imunológico
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Expert Rev Gastroenterol Hepatol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2023
Tipo de documento:
Article