Work

ABT score based clinical model predicts prognosis in unresectable hepatocellular carcinoma treated with TACE combined with bevacizumab and sintilimab therapy

Year: 2026

Type: article

Abstract: Background Transarterial chemoembolization combined with Bevacizumab and Sintilimab (T-B-S) therapy demonstrated promising treatment effects and improved prognosis in unresectable hepatocellular carcinoma (uHCC). However, biomarkers for predicting the treatment efficacy remain to be further explored. In this study, we aimed to construct a noninvasive and easily assessable clinical model, in order to predict prognosis of uHCC receiving T-B-S therapy. Methods 156 uHCC patients received T-B-S therapy were retrospectively recruited from three medical centers. Univariate and multivariate Cox regression analyses were used to identify independent prognostic factors for overall survival (OS). Model prediction potential was assessed by the receiver operating characteristic (ROC) curve and C-index. Survival curves were compared by Kaplan-Meier method. Results 156 uHCC patients were divided into training and validation cohorts (86 and 70 cases), and among all patients, 43 achieved complete response, 53 showed partial response, 32 had stable disease and 28 had progressive disease. The objective response and disease control rate were 61.5% and 82.1%, respectively. 23 patients underwent sequential resection (12 in training cohort and 11 in validation cohort). Univariate and multivariate Cox regression analyses identified alkaline phosphatase to prealbumin ratio (APR) > 0.96, BCLC-C stage and TBIL > 17 μmol/L as independent predictors of poor survival, which consist of the ABT score. The area under the receiver operating characteristic curve (AUC) of ABT model for predicting overall survival (OS) was 0.823 in training cohort and 0.828 in validation cohort. In training cohort, 2-year OS of different risk groups defined by ABT based clinical model were 89.8%, 43.7%, and 12.9%, respectively ( p < 0.0001). Progression free survival (PFS) of different risk groups was analyzed either. Conclusion The T-B-S therapy showed promising treatment efficacy. ABT based clinical model was constructed to predict survival of uHCC receiving T-B-S treatment and the ABT model performed well in risk stratification.

Source: Frontiers in Pharmacology

DOI: 10.3389/fphar.2026.1756451