Clinical Utility of a Prognostic Scoring System Based on LDH and CRP in HCC Patients Receiving Atezolizumab Plus Bevacizumab.
[AIM/BACKGROUND] This study aimed to validate the CLEAR score, a simple prognostic tool for hepatocellular carcinoma (HCC) patients undergoing atezolizumab plus bevacizumab (Atez/Bev) therapy, based o
- 표본수 (n) 280
- p-value p < 0.001
- 95% CI 1.48-2.64
APA
Tanaka K, Tsuji K, et al. (2025). Clinical Utility of a Prognostic Scoring System Based on LDH and CRP in HCC Patients Receiving Atezolizumab Plus Bevacizumab.. Liver international : official journal of the International Association for the Study of the Liver, 45(10), e70286. https://doi.org/10.1111/liv.70286
MLA
Tanaka K, et al.. "Clinical Utility of a Prognostic Scoring System Based on LDH and CRP in HCC Patients Receiving Atezolizumab Plus Bevacizumab.." Liver international : official journal of the International Association for the Study of the Liver, vol. 45, no. 10, 2025, pp. e70286.
PMID
40970650
Abstract
[AIM/BACKGROUND] This study aimed to validate the CLEAR score, a simple prognostic tool for hepatocellular carcinoma (HCC) patients undergoing atezolizumab plus bevacizumab (Atez/Bev) therapy, based on serum lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels.
[MATERIALS/METHODS] From 2020 to 2023, 498 Japanese HCC patients receiving Atez/Bev therapy were enrolled. They were divided into a training set (n = 280; 13 designated cancer care hospitals) and a validation set (n = 218; 11 universities and their affiliated Japanese hospitals). In the training set, prognostic factors were analysed, leading to the development of the CLEAR score, which was then evaluated on the validation set.
[RESULTS] Baseline LDH beyond the upper normal limit (hazard ratio [HR] 1.97, 95% CI 1.48-2.64) and CRP (≥ 0.50 mg/dL) (HR 1.61, 95% CI 1.19-2.00) were identified as independent prognostic factors on multivariate analysis and used in the CLEAR score. In the training set, the median progression-free survival (PFS) times in patients with scores 0, 1 and 2 were 11.1 months, 9.1 months and 3.3 months, respectively (p < 0.001). The median overall survival (OS) times in patients with scores 0, 1 and 2 were not available, 15.3 months and 10.6 months, respectively (p < 0.001). Similar results were obtained in the validation set (median PFS and OS times for scores 0, 1 and 2 = 9.4, 6.9 and 4.3 and 30.6, 20.8 and 8.9 months, respectively, each p < 0.001).
[CONCLUSION] The CLEAR score provides a distinct and simple prediction of the prognosis of HCC patients receiving Atez/Bev therapy.
[MATERIALS/METHODS] From 2020 to 2023, 498 Japanese HCC patients receiving Atez/Bev therapy were enrolled. They were divided into a training set (n = 280; 13 designated cancer care hospitals) and a validation set (n = 218; 11 universities and their affiliated Japanese hospitals). In the training set, prognostic factors were analysed, leading to the development of the CLEAR score, which was then evaluated on the validation set.
[RESULTS] Baseline LDH beyond the upper normal limit (hazard ratio [HR] 1.97, 95% CI 1.48-2.64) and CRP (≥ 0.50 mg/dL) (HR 1.61, 95% CI 1.19-2.00) were identified as independent prognostic factors on multivariate analysis and used in the CLEAR score. In the training set, the median progression-free survival (PFS) times in patients with scores 0, 1 and 2 were 11.1 months, 9.1 months and 3.3 months, respectively (p < 0.001). The median overall survival (OS) times in patients with scores 0, 1 and 2 were not available, 15.3 months and 10.6 months, respectively (p < 0.001). Similar results were obtained in the validation set (median PFS and OS times for scores 0, 1 and 2 = 9.4, 6.9 and 4.3 and 30.6, 20.8 and 8.9 months, respectively, each p < 0.001).
[CONCLUSION] The CLEAR score provides a distinct and simple prediction of the prognosis of HCC patients receiving Atez/Bev therapy.
MeSH Terms
Humans; Male; Female; Bevacizumab; C-Reactive Protein; Middle Aged; Antibodies, Monoclonal, Humanized; Liver Neoplasms; Aged; L-Lactate Dehydrogenase; Carcinoma, Hepatocellular; Prognosis; Antineoplastic Combined Chemotherapy Protocols; Japan; Retrospective Studies
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