Reductions in AFP and PIVKA-II can predict the efficiency of anti-PD-1 immunotherapy in HCC patients

• Published in: BMC cancer Vol. 21; no. 1; pp. 1 - 775
• Main Authors: Sun, Xuqi, Mei, Jie, Lin, Wenping, Yang, Ziliang, Peng, Wei, Chen, Jinbin, Zhang, Yaojun, Xu, Li, Chen, Minshan
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 04.07.2021; BioMed Central; BMC
• Subjects: AFP; Age; Alpha fetoproteins; Biomarkers; Cancer therapies; Dosage and administration; Drug dosages; Drug therapy; Efficiency; Gender; Health aspects; Hepatocellular carcinoma; Hepatoma; Immunotherapy; Liver cancer; Measurement; Metastasis; Monoclonal antibodies; Patients; PD-1 protein; Physiological aspects; PIVKA-II; Prognosis; Prothrombin; Survival; China
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-021-08428-w

Background Few biomarkers can predict the efficiency of PD-1 blockade in patients with hepatocellular carcinoma (HCC). This study aimed to investigate the prognostic role of AFP and PIVKA-II in HCC patients receiving anti-PD-1 immunotherapy. Methods A total of 235 HCC patients treated with PD-1 blockade were enrolled. Serum AFP and PIVKA-II levels were collected before and after treatments. The patients were divided into groups based on the reduction in AFP and PIVKA-II: AFP reduction [less than or equai to]50% vs AFP reduction > 50% and PIVKA-II reduction [less than or equai to]50% vs PIVKA-II reduction > 50%. The primary endpoints included objective response rate (ORR), progression-free survival (PFS) and overall survival (OS). Binary logistic regression analyses were used to explore the related factors of ORR. A Cox proportional hazards model was employed to identify the potential prognostic factors of PFS and OS. Results Among all the patients, 34.9% (82/235) achieved a complete or partial response. There was a positive correlation between AFP reduction > 50% or PIVKA-II reduction> 50% and the ORR of PD-1 blockade (P < 0.001 and = 0.003). PFS was significantly improved in patients with AFP reduction > 50% and PIVKA-II reduction > 50% (p < 0.001 and = 0.021). In addition, AFP reduction > 50% and PIVKA-II reduction> 50% were positively correlated with longer OS (p = 0.003 and 0.006). Conclusion Early reductions in AFP and PIVKA-II can be predictors of the efficacy of PD-1 blockade in HCC patients. Keywords: Hepatocellular carcinoma, AFP, PIVKA-II, Immunotherapy, Survival