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A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Prognosis of patients with advanced hepatocellular carcinoma who failed first-line systemic therapy
Yu-Yun Shao1, Chih-Horng Wu2, Li-Chun Lu3
1Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
Background & Aims:
No approved therapy is available for patients with advanced hepatocellular carcinoma (HCC) who fail first-line therapy. The prognosis of these patients, especially those eligible for clinical trials of second-line therapy, is unclear.
Methods:
All patients who participated in clinical trials of first-line systemic therapy for metastatic or locally advanced HCC in a referral center of Taiwan between 2005 and 2011 were included. Their clinicopathologic characteristics, when the first-line treatment failed, were analyzed and correlated with the overall survival (OS) from the date of first-line treatment failure.
Results:
A total of 192 patients were included. Before the start of the first-line therapy, all patients had Child-Pugh class A liver reserves and Cancer of the Liver Italian Program (CLIP) scores ≤4. After the failure of the first-line therapy, the median OS of the entire group was 4.0 months. Patients with Child-Pugh class A liver reserves, when the first-line treatment failed, had significantly better OS than patients with Child-Pugh class B or C liver reserves (median, A vs. B vs. C=7.5 vs. 1.3 vs. 1.0 month, p<0.001). According to the key eligibility criteria of 3 published clinical trials for second-line therapy, 41%-56% of patients were potentially eligible. Compared to patients who were ineligible for clinical trials, potentially eligible patients had longer OS with a median of 7.8-8.6 months.
Conclusions:
Patients with advanced HCC who failed first-line therapy could have substantially improved prognosis if they had Child-Pugh A liver reserves or were potentially eligible for clinical trials.
Insights
Patients with advanced liver cancer (HCC) who failed initial treatment have a better prognosis if they have good liver function (Child-Pugh A) or qualify for clinical trials. This offers hope for improved survival outcomes.
Area of Science:
- Hepatology
- Oncology
- Clinical Trials
Background:
- Advanced hepatocellular carcinoma (HCC) lacks approved therapies post-first-line treatment failure.
- Prognosis for these patients, particularly those eligible for second-line trials, remains unclear.
Purpose of the Study:
- To analyze the prognosis of advanced HCC patients after first-line therapy failure.
- To identify factors influencing overall survival (OS) in this patient cohort.
Main Methods:
- Retrospective analysis of 192 advanced HCC patients from clinical trials in Taiwan (2005-2011).
- Evaluation of clinicopathologic characteristics at first-line treatment failure.
- Correlation of these factors with overall survival (OS).
Main Results:
- Median OS after first-line failure was 4.0 months.
- Child-Pugh A liver reserves significantly improved OS (7.5 months) compared to B/C (1.0-1.3 months).
- 41%-56% of patients were eligible for second-line clinical trials, showing longer OS (7.8-8.6 months).
Conclusions:
- Good liver reserve (Child-Pugh A) and eligibility for clinical trials are key indicators for improved prognosis in advanced HCC post-first-line failure.
- These findings can guide treatment decisions and patient selection for further therapies.
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