循环y-55促炎性生物标志物对晚期HCC患者预后评估的动力学——SORAMIC试验的一项子研究

K. Schütte, J. Kupčinskas, Egidijus Morkūnas, O. Öcal, R. Schinner, M. Seidensticker, E. D. De Toni, N. Ben Khaled, M. Pech, D. Palmer, T. Berg, C. Sengel, B. Basu, J. Valle, J. Benckert, A. Gasbarrini, B. Sangro, P. Malfertheiner, J. Ricke
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摘要

引言预测晚期肝细胞癌(HCC)患者的治疗反应可能有助于选择个性化治疗。目的对SORAMIC试验(ClinicalTrials.gov NCT01126645)的姑息组进行探索性分析,评估全身白细胞介素6(IL-6)、白细胞介素8(IL-8)、全身血管内皮生长因子(VEGF)和脂多糖(LPS)水平的基础和动态变化的预后潜力。方法我们评估了90名患者在治疗开始后约7-9周的随访中,与基线(BL)相比,总生存期(OS)与IL-6、IL-8、VEGF和LPS浓度之间的相关性,这些患者要么接受90Y(90Y)微球联合索拉非尼(n=44)治疗,要么单独接受索拉非尼治疗(n=46)。结果治疗过程中IL-6浓度的变化与疗效相关。IL-6浓度比基线读数增加小于16.8 pg/mL与更好的生存率相关[中位OS 16.3个月,而8.9个月(p=0.0354)]。基线、FU时VEGF或LPS浓度或这些时间点之间的变化与生存率没有相关性。结论在SORAMIC试验中,治疗开始后7-9周血清IL-6水平的变化,而不是IL-8、VEGF或LPS的变化,为晚期HCC患者的预后提供了重要信息。
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Dynamics in Circulating y -55Proinflammatory Biomarkers for Prognostic Assessment of Patients With Advanced HCC – A Substudy From the SORAMIC Trial
Introduction Prediction of response to treatment in patients with advanced hepatocellular carcinoma (HCC) may assist in the selection of personalized management. Objective This exploratory analysis of the palliative arm of the SORAMIC trial (ClinicalTrials.gov NCT01126645) evaluated the prognostic potential of basal and dynamic changes in systemic levels of interleukin 6 (IL-6), interleukin 8 (IL-8), systemic vascular endothelial growth factor (VEGF), and lipopolysaccharide (LPS). Methods We evaluated the correlations between overall survival (OS) and concentrations of IL-6, IL-8, VEGF, and LPS at follow-up approximately 7-9 weeks after treatment initialization (FU) compared to baseline (BL) in 90 patients treated either with 90Yttrium (90Y) microspheres combined with sorafenib (n = 44) or with sorafenib (n = 46) alone. Results Changes in IL-6 concentration during treatment showed correlations with the outcome. An increase in IL-6 concentration of less than 16.8 pg/mL over baseline readings was associated with better survival [median OS 16.3 months compared with 8.9 months (p = 0.0354)]. Correlations with survival were not observed for VEGF or LPS concentrations at baseline, at FU, or changes between these time points. Conclusions Changes in IL 6 serum levels at 7-9 weeks after treatment initialization but not in IL 8, VEGF, or LPS add important information on the outcome of advanced HCC patients treated palliatively within the SORAMIC trial.
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