Prediction of therapeutic response of advanced hepatocellular carcinoma to combined targeted immunotherapy by MRI

• Published in: Magnetic resonance imaging Vol. 96; pp. 1 - 7
• Main Authors: Sheng, Ruofan, Jin, Kaipu, Sun, Wei, Gao, Shanshan, Zhang, Yunfei, Wu, Dong, Zeng, Mengsu
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.02.2023
• Subjects: Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - therapy; Combination treatment; Contrast Media; Gadolinium DTPA; Hepatocellular carcinoma; Humans; Immunotherapy; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - therapy; Magnetic Resonance Imaging; Retrospective Studies; Therapeutic response; Therapeutic response; Hepatocellular carcinoma; Combination treatment; Magnetic resonance imaging
• ISSN: 0730-725X; 1873-5894
• DOI: 10.1016/j.mri.2022.10.011

To assess the value of pre-treatment MRI in predicting treatment response to combined targeted immunotherapy in advanced hepatocellular carcinoma (HCC). Totally 35 HCC participants who underwent pre-treatment contrast-enhanced MRI and received combined tyrosine kinase inhibitor (TKI) and anti-PD-1 antibody treatment were enrolled. Univariable and multivariable logistic regression analyses were carried out for comparing clinical and MRI characteristics between patients with therapeutic response and those without. A predictive model based on MRI data and the corresponding nomogram were developed using data generated by multivariate analysis, and the diagnostic performance was evaluated. A cutoff for the combined index was measured by receiver operating characteristic curve analysis, and progression-free survival (PFS) rates were compared between cases with high and low combined index values. Fifteen (42.86%) cases achieved overall response during treatment. Multivariable analysis revealed that homogeneous signal (odds ratio [OR] = 13.51, P = 0.010) and no arterial peritumoral enhancement (APE; OR = 10.29, P = 0.024) independently predicted treatment response. The combined model including both significant MRI parameters showed a satisfactory predictive performance with the largest area under the curve of 0.837 (95%CI 0.673–0.939), and both sensitivity and specificity of 80.0%. HCCs with high-combined index had higher PFS rate compared with those showing a low value (P = 0.034). The combination of pre-treatment MRI features of homogeneous signal and no APE could be used for predicting treatment response to combined targeted immunotherapy in advanced HCC. •Pretreatment MRI can predict the response of targeted-immunotherapy in advanced HCC.•Homogeneous signal and no APE are related to therapeutic response.•The MRI-based combined model may help to identify appropriate therapeutic candidates.