KEY TAKEAWAYS
- The phase 3 IMbrave150 study examined the trajectory of α-fetoprotein (AFP) and evaluated the clinical outcomes in patients undergoing atezolizumab plus bevacizumab (Atez/Bev) therapy.
- This secondary analysis of IMbrave150 used multivariable Cox models to calculate adjusted HRs.
- Distinct AFP trajectories were observed in uHCC patients: low-stable (50%), sharp-falling (13.3%), and high-rising (36.7%).
- Lower AFP trajectories correlated with improved disease progression and survival. AFP trajectories played a significant role in patient outcomes.
The recent phase III IMbrave150 exploratory study delved into the potential of α-fetoprotein (AFP) as a biomarker for patients with unresectable hepatocellular carcinoma (uHCC) undergoing immunotherapy. The researchers focused on the use of atezolizumab plus bevacizumab (Atez/Bev) therapy. They aimed to identify various AFP trajectory patterns using latent class trajectory models. Multivariable Cox models were utilized to determine the HRs and 95% CIs linked with clinical outcomes.
The results revealed three distinct AFP trajectories among the uHCC patients who had undergone AFP measurements on seven different occasions (ranging from 3 to 28 times): low-stable (50.0%, n = 132), sharp-falling (13.3%, n = 35), and high-rising (36.7%, n = 97). Low-stable trajectory patients’ disease progression HRs was 0.52 (95% CI: 0.39, 0.70) vs high-rising trajectory patients with sharp-falling trajectory who had even lower HR of 0.26 (95% CI: 0.16, 0.43). The mortality rate of patients in the low-stable trajectory was 0.59 (95% CI: 0.40, 0.81), and the sharp-falling trajectory patients had a mortality rate of 0.30 (95% CI: 0.16, 0.57) after the propensity scores were adjusted. Notably, AFP trajectories exhibited the highest relative importance among all covariates in predicting patient survival.
Source: https://pubmed.ncbi.nlm.nih.gov/37422527/
Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT03434379
Lu L, Zheng P, Pan Y, Huang S, Shao E, Huang Y, Wang X, Chen Y, Cuo G, Yang H, Guo W, Shi Y, Wu Z, Chen X. Trajectories of α-fetoprotein and unresectable hepatocellular carcinoma outcomes receiving atezolizumab plus bevacizumab: a secondary analysis of IMbrave150 study. Br J Cancer. 2023 Jul 8. doi: 10.1038/s41416-023-02334-7. Epub ahead of print. PMID: 37422527.
