Prognostic Value of Clinical and CT Features in Camrelizumab Plus Apatinib Treatment for Unresectable Hepatocellular Carcinoma.

[BACKGROUND] Immunotherapy combined with targeted therapy is a key approach for patients with unresectable hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic value of clinical and CT features in Camrelizumab plus Apatinib treatment for these patients.

[MATERIALS AND METHODS] A retrospective study was conducted on unresectable HCC patients who received camrelizumab plus Apatinib treatment from June 2019 to August 2021. Clinical and contrast-enhanced CT features were analyzed. Logistic regression identified predictors of objective response, and Cox regression assessed prognostic factors for progression-free survival (PFS) and overall survival (OS). Nomograms were constructed based on independent predictors.

[RESULTS] Among 109 patients, the median OS was 20 months, median PFS was 9 months, and the ORR was 43.1%. Independent predictors of objective response included AFP ≥ 400 ng/mL (OR = 6.31), NLR ≥ 3.2 (OR = 3.72), tumor numbers ≥ 3 (OR = 3.93), and ΔAER < 15% (OR = 10.99), the AUC for objective response model was 0.874. Independent factors for PFS included AFP ≥ 400 ng/mL (HR = 2.04) and ΔAER < 15% (HR = 2.57), resulting in a model AUC of 0.859. Independent factors for OS were NLR ≥ 3.2 (HR = 2.07), Tumor numbers ≥ 3 (HR = 2.68), and extrahepatic metastasis (HR = 2.32), with an AUC of 0.848 and 0.866 for 1- and 2-year survival, respectively.

[CONCLUSION] Clinical and contrast-enhanced show significant prognostic value in patients receiving Camrelizumab plus Apatinib. The developed models may assist in identifying responsive patients and personalizing treatment strategies.