Impact of metabolic dysfunction-associated steatotic liver disease on the efficacy of immunotherapy in patients with chronic hepatitis B-related hepatocellular carcinoma.
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Abstract
Objective: To investigate the impact of metabolic dysfunction-associated steatotic liver disease (MASLD) on the efficacy of immune checkpoint inhibitor (ICI)-based therapy in patients with chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC).
Methods: A total of 155 patients with CHB-related HCC who received ICI-based therapy (in the Department of Hepatology, Tianjin Second People's Hospital and Department of Hepatobiliary Oncology, Tianjin Medical University Cancer Institute & Hospital) between April 2021 and December 2023 were evaluated. Patients were divided into two groups: MASLD concurrent with CHB [MASLD-CHB] (n = 38), and CHB (n = 117).
Results: The median progression-free survival (PFS, 6.9 months vs. 9.3 months; P = 0.001), progressive disease (57.89% vs. 37.61%; P = 0.028), and disease control rate (42.11% vs. 62.39%; P = 0. 028) in the MASLD-CHB group were significantly worse than the CHB group. The median overall survival was not attained. The percentage of CD4+PD1+ (17. 56% vs. 8.89%; P < 0.001) and CD8+PD1+ T cells (10.50% vs. 7.42%; P = 0.005) in patient samples from the MASLD-CHB group were significantly higher than the CHB group. Concurrent MASLD [hazard ratio (HR) = 1.921; 95% CI, 1.138-3.245; P = 0.015] and alpha-fetoprotein levels after 3 months of treatment (HR = 2.412; 95% CI, 1.360-4.279; P = 0.003) were independent risk factors for PFS in all patients.
Conclusions: ICI-based therapy in patients with CHB-related HCC and concurrent MASLD resulted in poorer efficacy and shorter PFS compared to patients with CHB-related HCC alone.
目的研究代谢功能障碍相关性脂肪性肝病（MASLD）对基于免疫检查点抑制剂（ICI）治疗的慢性乙型肝炎相关肝细胞癌（HCC）患者疗效的影响：对2021年4月至2023年12月期间接受ICI治疗的155例CHB相关HCC患者（天津市第二人民医院肝病科和天津医科大学肿瘤医院肝胆肿瘤科）进行评估。患者分为两组：MASLD并发CHB[MASLD-CHB]组（n = 38）和CHB组（n = 117）：结果：MASLD-CHB 组的中位无进展生存期（PFS，6.9 个月 vs. 9.3 个月；P = 0.001）、疾病进展率（57.89% vs. 37.61%；P = 0.028）和疾病控制率（42.11% vs. 62.39%；P = 0.028）均显著低于 CHB 组。总生存期未达到中位数。MASLD-CHB组患者样本中CD4+PD1+（17.56% vs. 8.89%; P < 0.001）和CD8+PD1+ T细胞（10.50% vs. 7.42%; P = 0.005）的比例明显高于CHB组。并发MASLD[危险比（HR）=1.921；95% CI，1.138-3.245；P=0.015]和治疗3个月后甲胎蛋白水平（HR=2.412；95% CI，1.360-4.279；P=0.003）是所有患者PFS的独立危险因素：结论：与单纯CHB相关HCC患者相比，对CHB相关HCC合并MASLD患者进行基于ICI的治疗，疗效较差，PFS较短。
期刊介绍：
Cancer Biology & Medicine (ISSN 2095-3941) is a peer-reviewed open-access journal of Chinese Anti-cancer Association (CACA), which is the leading professional society of oncology in China. The journal quarterly provides innovative and significant information on biological basis of cancer, cancer microenvironment, translational cancer research, and all aspects of clinical cancer research. The journal also publishes significant perspectives on indigenous cancer types in China.
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