Transcriptional Landscape of PD-1, PD-L1 and PD-L2 Correlated Genes and Their Association with Mutation, Immune Infiltration and Clinical Outcomes of Hepatocellular Carcinoma

Introduction: This study compared clinical outcomes of 2nd- and 3rd-line regorafenib in patients with unresectable hepatocellular carcinoma. Methods: In this retrospective cohort study, 48 patients were treated with regorafenib for unresectable hepatocellular carcinoma. Thirty-five and 13 patients were initiated on 2nd- and 3rd-line therapy, respectively. We assessed the responses to and safety of the therapy. Results: There were no statistically significant differences in clinical characteristics at the start of 2nd- or 3rd-line regorafenib therapy. The overall response rate of 2nd- and 3rd-line regorafenib was 20 and 8%, respectively. The disease control rate was 57 and 54%, respectively. Median overall survival (mOS) from the start of 2nd-line regorafenib was 17.5 months. mOS from the start of 3rd-line regorafenib was not obtained. Median progression-free survival of 2nd- and 3rd-line regorafenib was 4.9 and 2.3 months, respectively. mOS from 1st-line therapy with tyrosine kinase inhibitor plus sorafenib-regorafenib-lenvatinib was 29.5 months; that with lenvatinib-sorafenib-regorafenib was not obtained. Patients on 3rd-line therapy tended to have better Child-Pugh scores and tumor factors at the start of 1st-line therapy than other patients. Conclusion: Patients on 2nd- and 3rd-line regorafenib showed favorable responses. Good Child-Pugh scores and tumor factors may be associated with a better response rate and OS.

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Clinical outcomes of stereotactic body radiotherapy for elderly patients with hepatocellular carcinoma

Hepatology Research ◽

10.1111/hepr.12916 ◽

2017 ◽

Vol 48 (2) ◽

pp. 193-204 ◽

Cited By ~ 5

Author(s):

Yuji Teraoka ◽

Tomoki Kimura ◽

Hiroshi Aikata ◽

Kana Daijo ◽

Mitsutaka Osawa ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Elderly Patients ◽

Clinical Outcomes ◽

Stereotactic Body Radiotherapy

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Clinical outcomes of transarterial therapy for advanced hepatocellular carcinoma: is there evidence for expanding application?

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2014.12.496 ◽

2015 ◽

Vol 26 (2) ◽

pp. S185

Author(s):

J. Hansmann ◽

S.P. Zivin ◽

R. Jajko ◽

C.E. Ray ◽

M. Knuttinen ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Clinical Outcomes ◽

Advanced Hepatocellular Carcinoma

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Real-World Data on Clinical Outcomes of Patients with Liver Cancer: A Prospective Validation of the National Cancer Centre Singapore Consensus Guidelines for the Management of Hepatocellular Carcinoma

Liver Cancer ◽

10.1159/000514400 ◽

2021 ◽

pp. 1-16

Author(s):

Xin Hui Chew ◽

Rehena Sultana ◽

Eshani N. Mathew ◽

David Chee Eng Ng ◽

Richard H.G. Lo ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cancer ◽

Clinical Outcomes ◽

Real World ◽

Compliance Rate ◽

Locally Advanced ◽

Consensus Guidelines ◽

Real World Data ◽

World Data ◽

Cancer Centre

Introduction: Real-world management of patients with hepatocellular carcinoma (HCC) is crucially challenging in the current rapidly evolving clinical environment which includes the need for respecting patient preferences and autonomy. In this context, regional/national treatment guidelines nuanced to local demographics have increasing importance in guiding disease management. We report here real-world data on clinical outcomes in HCC from a validation of the Consensus Guidelines for HCC at the National Cancer Centre Singapore (NCCS). Method: We evaluated the NCCS guidelines using prospectively collected real-world data, comparing the efficacy of treatment received using overall survival (OS) and progression-free survival (PFS). Treatment outcomes were also independently evaluated against 2 external sets of guidelines, the Barcelona Clinic Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC). Results: Overall treatment compliance to the NCCS guidelines was 79.2%. Superior median OS was observed in patients receiving treatment compliant with NCCS guidelines for early (nonestimable vs. 23.5 months p < 0.0001), locally advanced (28.1 vs. 22.2 months p = 0.0216) and locally advanced with macrovascular invasion (10.3 vs. 3.3 months p = 0.0013) but not for metastatic HCC (8.1 vs. 6.8 months p = 0.6300), but PFS was similar. Better clinical outcomes were seen in BCLC C patients who received treatment compliant with NCCS guidelines than in patients with treatment only allowed by BCLC guidelines (median OS 14.2 vs. 7.4 months p = 0.0002; median PFS 6.1 vs. 4.0 months p = 0.0286). Clinical outcomes were, however, similar for patients across all HKLC stages receiving NCCS-recommended treatment regardless of whether their treatment was allowed by HKLC. Conclusion: The high overall compliance rate and satisfactory clinical outcomes of patients managed according to the NCCS guidelines confirm its validity. This validation using real-world data considers patient and treating clinician preferences, thus providing a realistic analysis of the usefulness of the NCCS guidelines when applied in the clinics.

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Sequential transarterial chemoembolization and early radiofrequency ablation improves clinical outcomes for early-intermediate hepatocellular carcinoma in a 10-year single-center comparative study

BMC Gastroenterology ◽

10.1186/s12876-021-01765-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Liangliang Yan ◽

Yanqiao Ren ◽

Kun Qian ◽

Xuefeng Kan ◽

Hongsen Zhang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Combination Therapy ◽

Clinical Outcomes ◽

Transarterial Chemoembolization ◽

Response Rate ◽

Multivariable Analysis ◽

Complication Rates ◽

Tace Treatment

Abstract Background Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective treatment methods for unresectable hepatocellular carcinoma (HCC). However, there is still a lack of clinical research on whether early sequential RFA, compared with late combination therapy, can improve the long-term efficacy of initial TACE treatment. Methods This retrospective study investigated a cohort of patients who underwent combination therapy using TACE and RFA (TACE followed by RFA) from January 2010 to January 2020 at our medical centre. A total of 96 patients underwent TACE combined with early RFA (usually during the first hospitalization), which was called TACE + eRFA. Thirty-four patients received 1–2 palliative TACE treatments first and then underwent TACE treatment combined with late RFA (TACE + lRFA). All patients continued to receive palliative TACE treatments after intrahepatic lesion progression until reaching intolerance. The overall survival (OS) rate, time to tumour progression (TTP), tumour response rate and major complication rates were compared between the two groups. Results There were significant differences in the median OS (46 months vs 33 months; P = 0.013), median TTP (28 months vs 14 months; P < 0.00), objective response rate (ORR) (89.6% vs 61.8%, P = 0.000) and disease control rate (DCR) (94.8% vs 73.5% P = 0.002) between the two groups. Multivariable analysis revealed that the Barcelona Clinic Liver Cancer stage was an independent risk factor for OS. Meanwhile, multivariable analysis revealed that TACE + eRFA was associated with an enhanced TTP. Conclusion Early sequential RFA treatment in patients with early-intermediate HCC can improve local tumour control and clinical outcomes while reducing the frequency of TACE treatment. In clinical practice, in HCC patients initially treated with TACE, it is recommended to combine RFA as soon as possible to obtain long-term survival.

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