The CRAFITY score emerges as a paramount prognostic indicator in hepatocellular carcinoma patients received Lenvatinib and Pembrolizumab.

IF 5.7 2区医学 Q1 IMMUNOLOGY Frontiers in Immunology Pub Date : 2024-11-01 eCollection Date: 2024-01-01 DOI:10.3389/fimmu.2024.1474456

Weijie Wu, Zhenyun Yang, Hao Zou, Teng Long, Zhongguo Zhou, Yaojun Zhang, Minshan Chen, Dandan Hu

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Abstract

Background: Levels of C-reactive protein (CRP) and alpha-fetoprotein (AFP) in immunotherapy (CRAFITY) scores are associated with the prognosis of patients with hepatocellular carcinoma (HCC). This study aimed to explore the efficacy of lenvatinib and pembrolizumab (Len-P) based on the CRAFITY score.

Methods: In this study, 228 patients with HCC who received Len-P in Sun Yat-sen University Cancer Center were included. CRAFITY 0 score was defined as AFP level below 100 ng/ml, CRP level below 1 mg/dl, CRAFITY 1 score was defined as AFP level at least 100 ng/ml or CRP level at least 1 mg/dl. CRAFITY 2 scores were defined as AFP levels exceeding 100 ng/ml and CRP levels exceeding 100 ng/ml. The primary outcome was overall survival (OS). The second outcome was tumor response rate.

Results: The survival time of CRAFITY 0 is significantly longer than that of CRAFITY 1 and CRAFITY 2 (p =.044). Univariate analysis showed that largest tumor size (HR = 2.149; 95% CI 1.129 - 4.091; p =.02), lymph node metastasis (HR = 2.012; 95% CI 1.132- 3.579; p = .017), and CRAFITY (HR = 0.372; 95% CI 0.168-0.824; p = .015) were important risk determinants of OS in all patients. The results of multivariate analysis show that CRAFITY score is an independent risk factors for OS (HR = 0.719; 95% CI 0.377-1.374; p =.048). The ORR of CRAFITY 0, 1 and 2 scores were 36.4%, 32% and 27.4%, respectively (p = .556). The ORR of intrahepatic lesions by CRAFITY 0, 1 and 2 were 37.9%, 35%, 30.6% (p= .688).

Conclusion: CRAFITY score is a good predictor of prognosis in HCC patients receiving Len-P.

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CRAFITY评分是肝细胞癌患者接受伦伐替尼和Pembrolizumab治疗后的重要预后指标。

背景：免疫疗法（CRAFITY）评分中的C反应蛋白（CRP）和甲胎蛋白（AFP）水平与肝细胞癌（HCC）患者的预后有关。本研究旨在根据CRAFITY评分探讨来伐替尼和pembrolizumab（Len-P）的疗效：本研究纳入了228例在中山大学附属肿瘤医院接受来那替尼治疗的HCC患者。CRAFITY 0 分定义为 AFP 水平低于 100 ng/ml，CRP 水平低于 1 mg/dl；CRAFITY 1 分定义为 AFP 水平至少 100 ng/ml 或 CRP 水平至少 1 mg/dl。CRAFITY 2 评分定义为 AFP 水平超过 100 ng/ml，CRP 水平超过 100 ng/ml。主要结果是总生存期（OS）。第二结果是肿瘤反应率：结果：CRAFITY 0 的生存时间明显长于 CRAFITY 1 和 CRAFITY 2（P =.044）。单变量分析显示，最大肿瘤尺寸（HR = 2.149; 95% CI 1.129 - 4.091; p =.02）、淋巴结转移（HR = 2.012; 95% CI 1.132- 3.579; p = .017）和CRAFITY（HR = 0.372; 95% CI 0.168-0.824; p = .015）是所有患者OS的重要风险决定因素。多变量分析结果显示，CRAFITY评分是OS的独立风险因素（HR = 0.719; 95% CI 0.377-1.374; p =.048）。CRAFITY0、1和2分的ORR分别为36.4%、32%和27.4%（P = .556）。CRAFITY0、1和2分的肝内病变ORR分别为37.9%、35%和30.6%（P= .688）：结论：CRAFITY评分可以很好地预测接受Len-P治疗的HCC患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Immunology IMMUNOLOGY-

CiteScore

9.80

自引率

11.00%

发文量

7153

审稿时长

14 weeks

期刊介绍： Frontiers in Immunology is a leading journal in its field, publishing rigorously peer-reviewed research across basic, translational and clinical immunology. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Immunology is the official Journal of the International Union of Immunological Societies (IUIS). Encompassing the entire field of Immunology, this journal welcomes papers that investigate basic mechanisms of immune system development and function, with a particular emphasis given to the description of the clinical and immunological phenotype of human immune disorders, and on the definition of their molecular basis.