Evidence map›Paper›PMID 36076009›Full record

ArticleHepatology international2023

Development and validation of a modified albumin-bilirubin grade and α-fetoprotein score (mALF score) for hepatocellular carcinoma patients receiving atezolizumab and bevacizumab.

Takeshi Hatanaka, Satoru Kakizaki, Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi and 30 more

Erratum issuedAbstract readMulticenter Study
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In one paragraph

Article in Hepatology international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

40 authors.

Takeshi HatanakaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Kamishindenmachi, Maebashi, Gunma, 564-1, Japan. hatanaka@qk9.so-net.ne.jp.ORCID http://orcid.org/0000-0003-3656-285X
Satoru KakizakiDepartment of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.ORCID https://orcid.org/0000-0002-1508-584X
Atsushi HiraokaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.ORCID https://orcid.org/0000-0003-1989-0480
Toshifumi TadaDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.ORCID https://orcid.org/0000-0002-0976-6761
Masashi HirookaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Kazuya KariyamaDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Joji TaniDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.
Masanori AtsukawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Koichi TakaguchiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Ei ItobayashiDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.
Shinya FukunishiPremier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Kunihiko TsujiCenter of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Toru IshikawaDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.ORCID https://orcid.org/0000-0002-5470-9694
Kazuto TajiriDepartment of Gastroenterology, Toyama University Hospital, Toyama, Japan.ORCID https://orcid.org/0000-0002-2373-8601
Hironori OchiCenter for Liver-Biliary-Pancreatic Disease, Matsuyama Red Cross Hospital, Matsuyama, Japan.
Satoshi YasudaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Hidenori ToyodaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.ORCID https://orcid.org/0000-0002-1652-6168
Chikara OgawaDepartment of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan.
Takashi NishimuraDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan.ORCID https://orcid.org/0000-0002-5517-8303
Noritomo ShimadaDivision of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan.
Kazuhito KawataHepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan.ORCID https://orcid.org/0000-0002-4986-8578
Hisashi KosakaDepartment of Surgery, Kansai Medical University, Hirakata, Japan.ORCID https://orcid.org/0000-0002-2926-9973
Takaaki TanakaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Hideko OhamaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Kazuhiro NousoDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.
Asahiro MorishitaDepartment of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan.ORCID https://orcid.org/0000-0002-0760-3045
Akemi TsutsuiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Takuya NaganoDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Norio ItokawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Tomomi OkuboDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Taeang AraiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Michitaka ImaiDepartment of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Atsushi NaganumaDepartment of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan.ORCID https://orcid.org/0000-0003-0663-0102
Yohei KoizumiDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Shinichiro NakamuraDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Masaki KaiboriDepartment of Surgery, Kansai Medical University, Hirakata, Japan.ORCID https://orcid.org/0000-0002-0577-3921
Hiroko IijimaDepartment of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan.ORCID https://orcid.org/0000-0002-5841-8827
Yoichi HiasaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.ORCID https://orcid.org/0000-0003-4117-339X
Takashi KumadaDepartment of Nursing, Gifu Kyoritsu University, Ogaki, Japan.ORCID https://orcid.org/0000-0003-2211-495X
Real-life Practice Experts for HCC (RELPEC) Study Group, and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimPredicting the survival of hepatocellular carcinoma (HCC) patients receiving atezolizumab and bevacizumab (Atez/bev) remains a challenge. This study aims to validate the modified albumin-bilirubin grade and α-fetoprotein score (mALF score).

methodsThis retrospective, multicenter study included 426 HCC patients receiving Atez/Bev. Each patient was randomized 3:2 to a training set (n = 255) and a validation set (n = 171). We investigated prognostic factors in the training set and developed an easily applicable mALF score, which was evaluated in the validation set.

resultsWe built the mALF score using baseline mALBI grade 2b or 3 (HR 2.36, 95% CI 1.37-4.05, p = 0.002) and α-fetoprotein ≥ 100 ng/ml (HR 2.61, 95% CI 1.49-4.55, p < 0.001), which were identified as unfavorable prognostic factors in a multivariate analysis. The 1-year OS rates were 82.7% (95% CI 68.9-90.8) in patients who meet neither of the criteria (mALF 0 points, n = 101), 61.7% (95% CI 44.5-74.9) in patients who meet either of the two criteria (mALF 1 point, n = 109), and 24.6% (95% CI 9.0-44.3) in patients who meet both criteria (mALF 2 points, n = 45); the difference was statistically significant (p < 0.001). The median PFS in patients with mALF 0, 1, and 2 points was 9.5 months (95% CI 4.3-NA), 6.6 months (95% CI 6.0-8.0), and 3.8 months (95% CI 3.0-5.2), respectively, which amounted to a significant difference (p < 0.001). These results were confirmed in the validation set (1-year OS rates, 0/1/2 points = 94.2%/62.1%/46.3%, p < 0.001; median PFS, 0/1/2 points = 9.3/6.7/4.7 months, p = 0.018).

conclusionThe mALF score can reliably predict the prognosis of HCC patients receiving Atez/Bev.

Indexed as

Carcinoma, HepatocellularLiver Neoplasmsalpha-FetoproteinsAntibodies, Monoclonal, HumanizedBevacizumabBilirubinHumansRetrospective StudiesSerum Albuminalpha-FetoproteinsAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabBilirubinSerum AlbuminAtezolizumabBevacizumabChild–Pugh classImmune checkpoint inhibitorLiver functionmALBI grademALF scoreOncologyPrognosisα-fetoprotein

Identifiers

PMID36076009

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