Work

Neutrophil‐to‐lymphocyte ratio at the start of the second course of durvalumab plus tremelimumab therapy predicts therapeutic efficacy in patients with advanced hepatocellular carcinoma: A multicenter analysis

Year: 2025

Type: article

Abstract: BACKGROUND AND AIMS: Durvalumab plus tremelimumab (Dur/Tre) therapy is expected to have good therapeutic efficacy for patients with unresectable hepatocellular carcinoma (u-HCC). We previously reported that the neutrophil-to-lymphocyte ratio (NLR) during atezolizumab plus bevacizumab therapy in u-HCC patients was a useful marker for predicting the therapeutic response. Therefore, we investigated whether the NLR during Dur/Tre therapy could predict treatment outcomes in patients with u-HCC. DESIGN: The present study included 64 u-HCC patients treated with Dur/Tre and evaluated for their initial response by dynamic computed tomography or magnetic resonance imaging at least once until December 2024. Alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) ratios were defined as follows: the pretreatment levels of AFP and DCP were set to 1, and the AFP and DCP ratios to pretreatment were calculated at the start of the second course of Dur/Tre therapy. RESULTS: Of the 64 HCC patients, 34 patients (53%) achieved a disease control rate (non-PD) at the initial evaluation. The NLR at the start of the second course (NLR-2c) tended to be lower in patients with non-PD than progressive disease (p = 0.133), and the optimal cutoff value was 5.75. Patients with NLR-2c ≥ 5.75 had a shorter progression-free survival (PFS) than those with NLR-2c < 5.75 (median: 1.7 vs. 5.5 months, p = 0.002). Multivariate analysis showed that NLR-2c ≥ 5.75 (HR 4.66; p < 0.001) and AFP ratio ≥ 0.933 (HR 4.32; p = 0.004) were significantly associated with poor PFS. CONCLUSIONS: The NLR-2c value is useful for predicting PFS in u-HCC patients treated with Dur/Tre therapy.

Source: Hepatology Research

DOI: 10.1111/hepr.14189