PMID- 38365678 OWN - NLM STAT- MEDLINE DCOM- 20240219 LR - 20240219 IS - 1471-2407 (Electronic) IS - 1471-2407 (Linking) VI - 24 IP - 1 DP - 2024 Feb 16 TI - Utility and predictive value of the CRAFITY score in advanced hepatocellular carcinoma treated with transarterial chemoembolization plus tyrosine kinase inhibitors and PD-1 inhibitor. PG - 223 LID - 10.1186/s12885-024-11936-0 [doi] LID - 223 AB - BACKGROUND: The prognostic significance of the CRAFITY score (CRP and AFP in ImmunoTherapY) has been demonstrated in hepatocellular carcinoma (HCC) patients receiving immunotherapy. The purpose of this study was to investigate the utility and the predictive value of CRAFITY score in HCC after transarterial chemoembolization (TACE) in combination with tyrosine kinase inhibitors (TKIs) and immunotherapy. MATERIALS AND METHODS: Data from patients with advanced HCC treated with TACE plus TKIs and PD-1 inhibitor from January 2019 to June 2022 were collected and analyzed retrospectively. Patients with AFP >/= 100 ng/mL and those with CRP >/= 1 mg/dL were assigned a CRAFITY score of 1 point. Patients were divided into three groups according to their CRAFITY score (CRAFITY-low, 0 points; CRAFITY-intermediate, 1 point; and CRAFITY-high, 2 points). The differences in overall survival (OS), progression-free survival (PFS) and adverse events (AEs) were compared among the three groups. Tumor response was evaluated at 3, 6 and 12 months after the first combination treatment. Risk factors for OS and PFS were assessed. RESULTS: A total of 70 patients were included. The patients were assigned CRAFITY scores of 0 points (CRAFITY-low, n = 25 [35.71%]), 1 point (CRAFITY-intermediate, n = 29 [41.42%]), and 2 points (CRAFITY-high, n = 16 [22.81%]). Multivariate analysis showed that lower CRAFITY score was an independent factor for the improved OS (P =.045) and PFS (P <.001). TACE session was also associated with the OS (P =.048) in the multivariate analysis. The CRAFITY-low cohort achieved a higher objective response rate (ORR) at the 3-month evaluation of tumor response. However, there was no significant difference in ORR and disease control rate (DCR) observed at the 6-month follow-up. DCR showed a statistically significant difference among three groups during the 12-month follow-up period. The percentage of patients with protein urea was highest in the CRAFITY-high group. No significance differences were observed in grade >/= 3 AEs in three groups. CONCLUSION: The CRAFITY score is simple and could be useful for predicting treatment outcomes, tumor response and AEs of the HCC patients receiving TACE plus TKIs and PD-1 inhibitor therapy. CI - (c) 2024. The Author(s). FAU - Zhang, Lijie AU - Zhang L AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. FAU - Sun, Tao AU - Sun T AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. FAU - Sun, Bo AU - Sun B AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. FAU - Zhang, Kailu AU - Zhang K AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. FAU - Zheng, Yuting AU - Zheng Y AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. FAU - Li, Na AU - Li N AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. FAU - Chen, Lei AU - Chen L AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. FAU - Zheng, Chuansheng AU - Zheng C AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. hqzcsxh@sina.com. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. hqzcsxh@sina.com. FAU - Liang, Bin AU - Liang B AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. bliang@hust.edu.cn. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. bliang@hust.edu.cn. FAU - Shi, Heshui AU - Shi H AD - Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, 430022, Wuhan, China. heshuishi@hust.edu.cn. AD - Hubei Province Key Laboratory of Molecular Imaging, 430022, Wuhan, China. heshuishi@hust.edu.cn. LA - eng GR - 2023fzyx008/Open Program of Hubei Province Key Laboratory of Molecular Imaging/ PT - Journal Article DEP - 20240216 PL - England TA - BMC Cancer JT - BMC cancer JID - 100967800 RN - 0 (Immune Checkpoint Inhibitors) RN - 0 (Tyrosine Kinase Inhibitors) RN - 0 (alpha-Fetoproteins) SB - IM MH - Humans MH - *Carcinoma, Hepatocellular/drug therapy MH - *Liver Neoplasms/therapy MH - Immune Checkpoint Inhibitors MH - Tyrosine Kinase Inhibitors MH - Retrospective Studies MH - alpha-Fetoproteins MH - *Chemoembolization, Therapeutic PMC - PMC10870627 OTO - NOTNLM OT - Hepatocellular carcinoma OT - PD-1 inhibitor OT - Transarterial chemoembolization OT - Tyrosine kinase inhibitors COIS- The authors declare no competing interests. EDAT- 2024/02/17 10:42 MHDA- 2024/02/19 06:43 PMCR- 2024/02/16 CRDT- 2024/02/16 23:36 PHST- 2023/09/27 00:00 [received] PHST- 2024/01/29 00:00 [accepted] PHST- 2024/02/19 06:43 [medline] PHST- 2024/02/17 10:42 [pubmed] PHST- 2024/02/16 23:36 [entrez] PHST- 2024/02/16 00:00 [pmc-release] AID - 10.1186/s12885-024-11936-0 [pii] AID - 11936 [pii] AID - 10.1186/s12885-024-11936-0 [doi] PST - epublish SO - BMC Cancer. 2024 Feb 16;24(1):223. doi: 10.1186/s12885-024-11936-0.