Yestle Kim, Dominic Nunag, Matthew Davis, Robert Gish
This retrospective observational cohort study was conducted using 100% Medicare fee-for-service claims data (10/01/2015–12/31/2021) to characterise risk of incident extrahepatic cancer in patients with non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) and for patients with MASH who progressed to more advanced liver disease (compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, liver transplant). For patients with non-cirrhotic MASH, 5-year cumulative incidence was 3.1% for breast cancer, 2.8% for lymphoma/leukaemia, 2.6% for prostate cancer and 1.4% for lung cancer. The greatest hazard of cancer incidence was observed for bladder (hazard ratio [HR] = 2.36), kidney (HR = 2.15), liver (HR = 2.48) and stomach cancers (HR = 3.38; all p < 0.05), each relative to control individuals without MASH/metabolic dysfunction-associated steatotic liver disease. Additionally, patients who progressed to advanced liver disease experienced a significantly increased hazard of several extrahepatic cancers. This study provides some of the first evidence on the incidence and risk of extrahepatic cancer among patients with MASH in the United States.
{"title":"Risk of Extrahepatic Cancer for Metabolic Dysfunction-Associated Steatohepatitis (MASH) in the United States Medicare Population","authors":"Yestle Kim, Dominic Nunag, Matthew Davis, Robert Gish","doi":"10.1111/liv.70508","DOIUrl":"10.1111/liv.70508","url":null,"abstract":"<div>\u0000 \u0000 <p>This retrospective observational cohort study was conducted using 100% Medicare fee-for-service claims data (10/01/2015–12/31/2021) to characterise risk of incident extrahepatic cancer in patients with non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) and for patients with MASH who progressed to more advanced liver disease (compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, liver transplant). For patients with non-cirrhotic MASH, 5-year cumulative incidence was 3.1% for breast cancer, 2.8% for lymphoma/leukaemia, 2.6% for prostate cancer and 1.4% for lung cancer. The greatest hazard of cancer incidence was observed for bladder (hazard ratio [HR] = 2.36), kidney (HR = 2.15), liver (HR = 2.48) and stomach cancers (HR = 3.38; all <i>p</i> < 0.05), each relative to control individuals without MASH/metabolic dysfunction-associated steatotic liver disease. Additionally, patients who progressed to advanced liver disease experienced a significantly increased hazard of several extrahepatic cancers. This study provides some of the first evidence on the incidence and risk of extrahepatic cancer among patients with MASH in the United States.</p>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nora Cazzagon, Martina Gambato, Maurizia Rossana Brunetto, Erica Villa, Patrizia Burra, Annarosa Floreani, Special Interest Group Gender in Hepatology of the Italian Association for the Study of the Liver (AISF)
The liver is central to sex hormone metabolism, and sex hormones in turn modulate hepatic physiology and disease processes. Oestrogens are often protective, while androgens tend to worsen disease progression. The clinical implications of hormonal therapies in patients with liver disease remain an area of active investigation. To review current evidence on the interplay between sex hormones and liver disease, with a focus on the safety and impact of hormonal therapies, including contraception, hormone replacement therapy, assisted reproductive technology and gender-affirming treatments. Prolonged or high-dose oestrogen exposure, particularly via oral contraceptives, has been associated with intrahepatic cholestasis and hepatocellular adenoma (HCA), especially in predisposed individuals. In contrast, hormone replacement therapy in postmenopausal women is generally safe and may confer metabolic and hepatic benefits. Oestrogens appear to slow fibrosis progression and reduce hepatocellular carcinoma risk, whereas androgens can promote steatosis and HBV-related oncogenesis. Hormonal therapies are safe in most patients with compensated chronic liver disease but require caution in settings such as in polycystic liver disease, where oestrogens can accelerate cyst growth. Emerging data also indicate a role of sex hormones in autoimmune and cholestatic diseases, as well as in outcomes of assisted reproduction and gender-affirming therapy. Hormonal therapies are feasible in most liver disease contexts, but individualised assessment, awareness of genetic predisposition, and disease-specific risks are essential to optimise safety and therapeutic benefit.
{"title":"Sex Hormones and the Liver: Implications for Disease Progression and Hormonal Therapy","authors":"Nora Cazzagon, Martina Gambato, Maurizia Rossana Brunetto, Erica Villa, Patrizia Burra, Annarosa Floreani, Special Interest Group Gender in Hepatology of the Italian Association for the Study of the Liver (AISF)","doi":"10.1111/liv.70509","DOIUrl":"10.1111/liv.70509","url":null,"abstract":"<p>The liver is central to sex hormone metabolism, and sex hormones in turn modulate hepatic physiology and disease processes. Oestrogens are often protective, while androgens tend to worsen disease progression. The clinical implications of hormonal therapies in patients with liver disease remain an area of active investigation. To review current evidence on the interplay between sex hormones and liver disease, with a focus on the safety and impact of hormonal therapies, including contraception, hormone replacement therapy, assisted reproductive technology and gender-affirming treatments. Prolonged or high-dose oestrogen exposure, particularly via oral contraceptives, has been associated with intrahepatic cholestasis and hepatocellular adenoma (HCA), especially in predisposed individuals. In contrast, hormone replacement therapy in postmenopausal women is generally safe and may confer metabolic and hepatic benefits. Oestrogens appear to slow fibrosis progression and reduce hepatocellular carcinoma risk, whereas androgens can promote steatosis and HBV-related oncogenesis. Hormonal therapies are safe in most patients with compensated chronic liver disease but require caution in settings such as in polycystic liver disease, where oestrogens can accelerate cyst growth. Emerging data also indicate a role of sex hormones in autoimmune and cholestatic diseases, as well as in outcomes of assisted reproduction and gender-affirming therapy. Hormonal therapies are feasible in most liver disease contexts, but individualised assessment, awareness of genetic predisposition, and disease-specific risks are essential to optimise safety and therapeutic benefit.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clara Oliveras, Mercè Balcells-Oliveró, Ramón Bataller, Pol Bruguera, Noel Cabrera, Cristina Calomarde-Gomez, Elsa Caballeria, Neus Freixa, Óscar Garcia-Pañella, Jordi Gratacós-Ginès, Pablo Guzman, Anna Hernández-Rubio, Anna Lligoña, Lluisa Ortega, Martina Pérez-Guasch, María Teresa Pons-Cabrera, Elisa Pose, Paola Zuluaga, Hugo López-Pelayo
Background
Alcohol-related liver disease (ArLD) is a public health concern that requires multidisciplinary interventions. Digital health tools may improve retention in alcohol use disorder (AUD) treatment and enhance health outcomes. This study explores a blended intervention (brief intervention plus a serious game (SG) based on motivational interviewing and cognitive-behavioural therapy) on AUD in patients with ArLD.
Methods
Randomised, single-blinded controlled trial on patients with recent-onset ArLD and AUD. Brief intervention plus the SG was compared to standard addiction therapy. Primary outcomes were AUD treatment retention and adherence at 6 months. Secondary outcomes included liver disease progression, alcohol use patterns, quality of life, functionality, motivational changes and usability.
Results
Seventy-nine patients (mean age 56, MELD-Na 14) were included. Participants in the intervention arm were three times more likely to remain in treatment at month six than those in the control arm (adjusted odds ratio (aOR) 3.24; 82.9% vs. 47.4% of engagement respectively) and attended 50% more appointments. Effect sizes (Cohen's D) were moderate for adherence at months three and six (0.51–0.64). At 6 months, Model for End-Stage Liver Disease Sodium (MELD-Na) scores were lower in the experimental group (12 vs. 16, p < 0.001). Among baseline drinkers, alcohol consumption decreased more in the intervention group at month one (11 vs. 6 Standard Drink Units (SDU)/day, p = 0.031).
Conclusion
The blended intervention increases engagement with AUD treatment, reduces the amount of consumed alcohol and improves MELD-Na scores. These results support the use of digital tailored interventions for AUD in these patients.
背景：酒精相关性肝病（ArLD）是一个需要多学科干预的公共卫生问题。数字健康工具可以提高酒精使用障碍（AUD）治疗的保留率，并提高健康结果。本研究探讨了一种混合干预（简短干预加基于动机访谈和认知行为治疗的严肃游戏）对ArLD患者AUD的影响。方法：随机、单盲对照试验，纳入新近发病的ArLD和AUD患者。将短暂干预加SG与标准成瘾治疗进行比较。主要结果是6个月时AUD治疗的保留和依从性。次要结局包括肝病进展、酒精使用模式、生活质量、功能、动机变化和可用性。结果：纳入79例患者，平均年龄56岁，MELD-Na 14岁。干预组的参与者在第六个月继续接受治疗的可能性是对照组的三倍(调整后的优势比（aOR） 3.24；（82.9% vs. 47.4%），赴约率高出50%。在第3个月和第6个月，依从性的效应量（Cohen's D）为中等（0.51-0.64）。6个月时，实验组的终末期肝病模型钠（MELD-Na）评分较低（12比16，p）。结论：混合干预增加了AUD治疗的参与程度，减少了饮酒量，提高了MELD-Na评分。这些结果支持在这些患者中使用数字定制的AUD干预措施。
{"title":"MyWayUp: A Digital Intervention for Alcohol Use Disorder in Patients With Alcohol-Related Liver Disease—Results From an RCT","authors":"Clara Oliveras, Mercè Balcells-Oliveró, Ramón Bataller, Pol Bruguera, Noel Cabrera, Cristina Calomarde-Gomez, Elsa Caballeria, Neus Freixa, Óscar Garcia-Pañella, Jordi Gratacós-Ginès, Pablo Guzman, Anna Hernández-Rubio, Anna Lligoña, Lluisa Ortega, Martina Pérez-Guasch, María Teresa Pons-Cabrera, Elisa Pose, Paola Zuluaga, Hugo López-Pelayo","doi":"10.1111/liv.70506","DOIUrl":"10.1111/liv.70506","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alcohol-related liver disease (ArLD) is a public health concern that requires multidisciplinary interventions. Digital health tools may improve retention in alcohol use disorder (AUD) treatment and enhance health outcomes. This study explores a blended intervention (brief intervention plus a serious game (SG) based on motivational interviewing and cognitive-behavioural therapy) on AUD in patients with ArLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Randomised, single-blinded controlled trial on patients with recent-onset ArLD and AUD. Brief intervention plus the SG was compared to standard addiction therapy. Primary outcomes were AUD treatment retention and adherence at 6 months. Secondary outcomes included liver disease progression, alcohol use patterns, quality of life, functionality, motivational changes and usability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-nine patients (mean age 56, MELD-Na 14) were included. Participants in the intervention arm were three times more likely to remain in treatment at month six than those in the control arm (adjusted odds ratio (aOR) 3.24; 82.9% vs. 47.4% of engagement respectively) and attended 50% more appointments. Effect sizes (Cohen's D) were moderate for adherence at months three and six (0.51–0.64). At 6 months, Model for End-Stage Liver Disease Sodium (MELD-Na) scores were lower in the experimental group (12 vs. 16, <i>p</i> < 0.001). Among baseline drinkers, alcohol consumption decreased more in the intervention group at month one (11 vs. 6 Standard Drink Units (SDU)/day, <i>p</i> = 0.031).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The blended intervention increases engagement with AUD treatment, reduces the amount of consumed alcohol and improves MELD-Na scores. These results support the use of digital tailored interventions for AUD in these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reassessing the Clinical Interpretation of Atezolizumab Plus Bevacizumab in Child-Pugh B Hepatocellular Carcinoma","authors":"Ze Xiang, Yunyang Xu, Shuhui Li, Jian Wu","doi":"10.1111/liv.70510","DOIUrl":"10.1111/liv.70510","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the Editor: Machine Learning Models for Screening Steatosis in MASLD: An International Validation Study","authors":"Basile Njei, Ulrick Sidney Kanmounye","doi":"10.1111/liv.70500","DOIUrl":"10.1111/liv.70500","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Li Ma, Jingqin Ma, Yaozu Liu, Yongjie Zhou, Jiaze Yu, Minjie Yang, Wen Zhang, Jianjun Luo, Zhiping Yan
Background and Aims
While remeasuring portacaval pressure gradient (PPG) after transjugular intrahepatic portosystemic shunt (TIPS), it provides superior prognostic information, and its clinical utility is limited by invasiveness. We aimed to develop and validate an explainable machine learning (ML) model for predicting short-term PPG changes and improving prognostic value of PPG in cirrhotic patients undergoing TIPS.
Methods
We enrolled 328 and 128 patients (2018–2023) in retrospective training and prospective validation cohorts, respectively. PPG was measured pre-TIPS, immediately (imePPG) and 2–4 days post-TIPS (delPPG). All ML models were developed using hyperparameter tuning with 5-fold cross-validation.
Results
Support vector regression model (SVR_RBF) demonstrated superior performance across feature subsets, with its 6-feature model achieving optimal balance between robustness and simplicity. In the validation cohort, the final model significantly improved PPG agreement (R-squared: 0.265–0.617, mean square error: 16.64–4.90, mean absolute error: 3.45–1.65, intraclass correlation coefficient: 0.533–0.841). SHapley Additive exPlanation analysis identified imePPG reduction from baseline as the primary determinant of subsequent PPG changes. Restricted cubic spline analyses revealed significant nonlinear relationships between relative PPG reduction (but not absolute values) and 2-year further decompensation in the training cohort. Optimal reduction thresholds were defined as U-shaped curves with hazard ratio (HR) nodes at 1 (imePPG: 30%–70%, delPPG: 20%–55%), which were validated in the prospective cohort showing significant associations for both true (p = 0.003, HR = 0.45) and predicted (p = 0.044, HR = 0.57) delPPG, but not for imePPG (p = 0.196).
Conclusions
The six-feature SVR_RBF model enhances the accuracy and prognostic utility of PPG measurements before TIPS completion, supporting clinical decision-making without additional invasive assessments.
{"title":"An Explainable Machine Learning Model for Predicting Short-Term Haemodynamic Changes Post-TIPS With Prognostic Implications","authors":"Li Ma, Jingqin Ma, Yaozu Liu, Yongjie Zhou, Jiaze Yu, Minjie Yang, Wen Zhang, Jianjun Luo, Zhiping Yan","doi":"10.1111/liv.70505","DOIUrl":"10.1111/liv.70505","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>While remeasuring portacaval pressure gradient (PPG) after transjugular intrahepatic portosystemic shunt (TIPS), it provides superior prognostic information, and its clinical utility is limited by invasiveness. We aimed to develop and validate an explainable machine learning (ML) model for predicting short-term PPG changes and improving prognostic value of PPG in cirrhotic patients undergoing TIPS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 328 and 128 patients (2018–2023) in retrospective training and prospective validation cohorts, respectively. PPG was measured pre-TIPS, immediately (imePPG) and 2–4 days post-TIPS (delPPG). All ML models were developed using hyperparameter tuning with 5-fold cross-validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Support vector regression model (SVR_RBF) demonstrated superior performance across feature subsets, with its 6-feature model achieving optimal balance between robustness and simplicity. In the validation cohort, the final model significantly improved PPG agreement (R-squared: 0.265–0.617, mean square error: 16.64–4.90, mean absolute error: 3.45–1.65, intraclass correlation coefficient: 0.533–0.841). SHapley Additive exPlanation analysis identified imePPG reduction from baseline as the primary determinant of subsequent PPG changes. Restricted cubic spline analyses revealed significant nonlinear relationships between relative PPG reduction (but not absolute values) and 2-year further decompensation in the training cohort. Optimal reduction thresholds were defined as U-shaped curves with hazard ratio (HR) nodes at 1 (imePPG: 30%–70%, delPPG: 20%–55%), which were validated in the prospective cohort showing significant associations for both true (<i>p</i> = 0.003, HR = 0.45) and predicted (<i>p</i> = 0.044, HR = 0.57) delPPG, but not for imePPG (<i>p</i> = 0.196).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The six-feature SVR_RBF model enhances the accuracy and prognostic utility of PPG measurements before TIPS completion, supporting clinical decision-making without additional invasive assessments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chiara Pircher, Federico Nichetti, Mario Domenico Rizzato, Maria Bensi, Francesca Salani, Rita Balsano, Simone Rota, Carolina Sciortino, Giacomo Di Paolo, Giovanni Trovato, Virginia Genovesi, Silvia Bozzarelli, Michele Droz Dit Busset, Silvia Marchesi, Eleonora Gusmaroli, Vincenzo Mazzaferro, Lisa Salvatore, Caterina Vivaldi, Sara Sperotto, Lorenza Rimassa, Filippo de Braud, Filippo Pietrantonio, Sara Lonardi, Monica Niger
Background
FOLFOX (folinic acid, 5-fluorouracil, oxaliplatin) is the standard second-line treatment in patients with biliary tract cancer (BTC) not eligible for targeted therapies. FOLFIRI (folinic acid, 5-fluorouracil, irinotecan) is a frequently adopted alternative combination in clinical practice, especially in patients primarily refractory to platinum-based first-line treatment. However, a real-world direct comparison between the two regimens has not yet been reported.
Methods
We performed a multicenter, retrospective analysis comparing patients with advanced BTC treated with cisplatin-gemcitabine, with or without durvalumab, as first-line and FOLFIRI or FOLFOX as second-line therapy. The primary endpoints were overall survival (OS) and progression free survival (PFS), as evaluated from the start of second-line, according to the chosen regimen. Multivariable models were tested, also considering prior cisplatin sensitivity and BRCAness status according to tumour molecular profiling. Clinical differences between the FOLFOX and FOLFIRI arms were balanced through inverse probability of treatment weighting (IPTW) methodology.
Results
A total of 259 patients were included, of whom 109 were treated with FOLFOX and 150 with FOLFIRI. Patient and tumour characteristics were overall balanced between the two arms. No significant difference between FOLFIRI and FOLFOX was observed in terms of PFS (median 3.1 vs. 3.5 months, HR 1.01; IPTW-adjusted median 3.2 vs. 3.5 months, HR 0.86) or OS (median 9.9 vs. 9.0 months, HR 1.09; IPTW-adjusted median 10.0 vs. 8.9 months, HR 1.04), with platinum sensitivity and BRCAness status emerging as independent prognostic factors.
Conclusions
FOLFOX and FOLFIRI showed modest, comparable efficacy as second-line regimens in patients with BTC pretreated with cisplatin-gemcitabine, with platinum-sensitive patients experiencing significantly longer PFS and OS, independently of the chosen second-line regimen.
背景：FOLFOX （folinic acid， 5-氟尿嘧啶，奥沙利铂）是不符合靶向治疗条件的胆道癌（BTC）患者的标准二线治疗。FOLFIRI（亚叶酸、5-氟尿嘧啶、伊立替康）是临床实践中经常采用的替代组合，特别是在对铂类一线治疗主要难治的患者中。然而，两种方案之间的实际直接比较尚未有报道。方法：我们进行了一项多中心回顾性分析，比较使用顺铂-吉西他滨治疗的晚期BTC患者，使用或不使用杜伐单抗，作为一线治疗和FOLFIRI或FOLFOX作为二线治疗。主要终点是总生存期（OS）和无进展生存期（PFS），根据所选方案从二线开始评估。我们测试了多变量模型，并根据肿瘤分子谱考虑了既往顺铂敏感性和BRCAness状态。通过治疗加权逆概率（IPTW）方法平衡FOLFOX组和FOLFIRI组的临床差异。结果：共纳入259例患者，其中FOLFOX治疗109例，FOLFIRI治疗150例。患者和肿瘤特征在两组之间总体平衡。FOLFIRI和FOLFOX在PFS（中位3.1 vs 3.5个月，HR 1.01； iptw调整后中位3.2 vs 3.5个月，HR 0.86）或OS（中位9.9 vs 9.0个月，HR 1.09； iptw调整后中位10.0 vs 8.9个月，HR 1.04）方面没有观察到显著差异，铂敏感性和BRCAness状态成为独立的预后因素。结论：在顺铂-吉西他滨预处理的BTC患者中，FOLFOX和FOLFIRI作为二线方案显示出适度的、相当的疗效，与所选择的二线方案无关，铂敏感患者的PFS和OS显着延长。
{"title":"FOLFOX Versus FOLFIRI as Second-Line Chemotherapy in Patients With Advanced Biliary Tract Cancers: A Multicenter, Italian Study","authors":"Chiara Pircher, Federico Nichetti, Mario Domenico Rizzato, Maria Bensi, Francesca Salani, Rita Balsano, Simone Rota, Carolina Sciortino, Giacomo Di Paolo, Giovanni Trovato, Virginia Genovesi, Silvia Bozzarelli, Michele Droz Dit Busset, Silvia Marchesi, Eleonora Gusmaroli, Vincenzo Mazzaferro, Lisa Salvatore, Caterina Vivaldi, Sara Sperotto, Lorenza Rimassa, Filippo de Braud, Filippo Pietrantonio, Sara Lonardi, Monica Niger","doi":"10.1111/liv.70502","DOIUrl":"10.1111/liv.70502","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>FOLFOX (folinic acid, 5-fluorouracil, oxaliplatin) is the standard second-line treatment in patients with biliary tract cancer (BTC) not eligible for targeted therapies. FOLFIRI (folinic acid, 5-fluorouracil, irinotecan) is a frequently adopted alternative combination in clinical practice, especially in patients primarily refractory to platinum-based first-line treatment. However, a real-world direct comparison between the two regimens has not yet been reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a multicenter, retrospective analysis comparing patients with advanced BTC treated with cisplatin-gemcitabine, with or without durvalumab, as first-line and FOLFIRI or FOLFOX as second-line therapy. The primary endpoints were overall survival (OS) and progression free survival (PFS), as evaluated from the start of second-line, according to the chosen regimen. Multivariable models were tested, also considering prior cisplatin sensitivity and BRCAness status according to tumour molecular profiling. Clinical differences between the FOLFOX and FOLFIRI arms were balanced through inverse probability of treatment weighting (IPTW) methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 259 patients were included, of whom 109 were treated with FOLFOX and 150 with FOLFIRI. Patient and tumour characteristics were overall balanced between the two arms. No significant difference between FOLFIRI and FOLFOX was observed in terms of PFS (median 3.1 vs. 3.5 months, HR 1.01; IPTW-adjusted median 3.2 vs. 3.5 months, HR 0.86) or OS (median 9.9 vs. 9.0 months, HR 1.09; IPTW-adjusted median 10.0 vs. 8.9 months, HR 1.04), with platinum sensitivity and BRCAness status emerging as independent prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FOLFOX and FOLFIRI showed modest, comparable efficacy as second-line regimens in patients with BTC pretreated with cisplatin-gemcitabine, with platinum-sensitive patients experiencing significantly longer PFS and OS, independently of the chosen second-line regimen.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Liu, X. Zhang, X. Cheng, Q. He, T. Zhou, H. Wang, B. Li, W. Luo, J. Li, H. Li, Z. Lin, J. Song, W. Wang, J. Huang, Y. Ji, D. Zhou, W. Xie, Q. Yang, M. Tu, X. Luo, X. Zhang, H. Yan, J. Chen, “Indocyanine Green Clearance Test via Pulse Dye Densitometry for Portal Hypertension Diagnosis in cACLD,” Liver International 45, no. 12 (2025): e70425, 10.1111/liv.70425.
We noticed an error in the co-first author contribution statement, which incorrectly listed Xiao Cheng twice and omitted Qinjun He.
The correct co-first contribution statement should read: Miaoxia Liu, Xiaofeng Zhang, Xiao Cheng, Qinjun He and Tiantian Zhou contributed equally to this study.
We apologise for this error.
刘敏，张晓霞，程晓霞，何其清，周涛，王红红，李斌，罗伟，李静，李宏，林志杰，宋建军，王伟，黄军，季勇，周德华，谢伟，杨琴，涂敏，罗晓霞，张晓霞，严宏，陈俊，“脉冲染料密度法检测门静脉高压症诊断中的Indocyanine Green Clearance Test”，《国际肝病》第45期，第1期。12 (2025): e70425, 10.1111/ live .70425。我们注意到共同第一作者贡献声明中有一个错误，错误地两次列出了肖成，并省略了何勤军。正确的共同第一贡献声明应为：Miaoxia Liu、Xiaofeng Zhang、Xiao Cheng、qjun He和Tiantian Zhou对本研究的贡献相同。我们为这个错误道歉。
{"title":"Correction to ‘Indocyanine Green Clearance Test via Pulse Dye Densitometry for Portal Hypertension Diagnosis in cACLD’","authors":"","doi":"10.1111/liv.70496","DOIUrl":"10.1111/liv.70496","url":null,"abstract":"<p>M. Liu, X. Zhang, X. Cheng, Q. He, T. Zhou, H. Wang, B. Li, W. Luo, J. Li, H. Li, Z. Lin, J. Song, W. Wang, J. Huang, Y. Ji, D. Zhou, W. Xie, Q. Yang, M. Tu, X. Luo, X. Zhang, H. Yan, J. Chen, “Indocyanine Green Clearance Test via Pulse Dye Densitometry for Portal Hypertension Diagnosis in cACLD,” <i>Liver International</i> 45, no. 12 (2025): e70425, 10.1111/liv.70425.</p><p>We noticed an error in the co-first author contribution statement, which incorrectly listed Xiao Cheng twice and omitted Qinjun He.</p><p>The correct co-first contribution statement should read: Miaoxia Liu, Xiaofeng Zhang, <b>Xiao Cheng, Qinjun He</b> and Tiantian Zhou contributed equally to this study.</p><p>We apologise for this error.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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