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Related Experiment Video

Updated: Jun 27, 2025

An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
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The pattern of tumor progression on first-line immune checkpoint inhibitor-based systemic therapy for Chinese

Chao-Xu Yang1, Yang-Xun Pan2, Feng Ye3

  • 1Medical Oncology, Nanjing Jinling Hospital, Nanjing, China.

Frontiers in Immunology
|May 7, 2024
PubMed
Summary

This study identified four distinct progression patterns in advanced hepatocellular carcinoma patients treated with immune checkpoint inhibitors, revealing significant differences in survival outcomes. These findings highlight the need for personalized treatment strategies based on progression patterns and alpha-fetoprotein levels.

Keywords:
hepatocellular carcinomaimmunotherapypostprogression survivalprognostic modelprogression pattern

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Area of Science:

  • Oncology
  • Immunotherapy
  • Hepatocellular Carcinoma Research

Background:

  • Lack of standardized restratification criteria after immune checkpoint inhibitor (ICI) progression in advanced hepatocellular carcinoma (HCC).
  • Need to understand disease progression patterns in patients ineligible for surgery post-ICI treatment.

Purpose of the Study:

  • To assess disease progression patterns in advanced HCC patients after first-line immune checkpoint inhibitor therapy.
  • To evaluate the impact of these patterns on post-progression survival (PPS) and overall survival (OS).

Main Methods:

  • Retrospective analysis of inoperable China liver stage (CNLC) IIIa/IIIb HCC patients treated with ICIs across eight Chinese centers (Jan 2017-Oct 2022).
  • Assessment of progression patterns using RECIST 1.1 criteria and identification of four distinct modes (p-IIb, p-IIIa, p-IIIb, p-IIIc).
  • Kaplan-Meier method for survival analysis (PPS and OS); subgroup analysis for immunotherapy combinations and alpha-fetoprotein (AFP) levels (≥400ng/mL vs. <400ng/mL).

Main Results:

  • Four distinct progression patterns (p-IIb, p-IIIa, p-IIIb, p-IIIc) were identified with significant variations in PPS and OS.
  • p-IIb showed the longest PPS (12.7m) and OS (19.6m), while p-IIIa had the shortest PPS (3.4m) and OS (8.2m).
  • Patients with AFP ≥400ng/mL had no significant difference in OS or PPS with different immunotherapy regimens but experienced a shorter median PPS (5.0 months) compared to those with AFP <400ng/mL (8.0 months).

Conclusions:

  • Distinct progression patterns in advanced HCC after ICI therapy significantly impact patient prognosis, underscoring disease heterogeneity.
  • Development of prognostic models integrating these progression patterns is crucial for guiding subsequent treatment decisions.
  • Elevated AFP levels (≥400ng/mL) post-immunotherapy indicate a poorer prognosis, necessitating tailored management strategies.