ArticleFrontiers in immunology2024
Nomograms confirm serum IL-6 and CRP as predictors of immune checkpoint inhibitor efficacy in unresectable hepatocellular carcinoma.
Article in Frontiers in immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- The load of hepatitis B virus reduces the immune checkpoint inhibitors efficiency in hepatocellular carcinoma patients.Frontiers in immunology · 2024Pooled it
- On-treatment modified Glasgow Prognostic Score (mGPS) in hepatocellular carcinoma treated with atezolizumab and bevacizumab provides prognostic information.Frontiers in immunology · 2025Trial
- Prognostic significance of circulating immune-inflammatory biomarkers IL-6 and systemic immune-inflammation index in hepatocellular carcinoma treated with immune checkpoint inhibitors: A meta-analysis.Journal of medical biochemistry · 2026Article
- Trained immunity as a systemic bridge: the liver-gut-immune-oral axis in the comorbidity of chronic liver disease and periodontitis.Frontiers in immunology · 2026Review
- Early C-reactive protein kinetics predict outcomes in unresectable hepatocellular carcinoma treated with immune checkpoint inhibitors: a multicenter, observational study comparing different C-reactive protein kinetic definitions.Frontiers in oncology · 2026Article
- Dynamic inflammatory biomarkers as prognostic indicators in advanced breast cancer patients receiving PD-1 inhibitors.Therapeutic advances in medical oncology · 2026Article
- Role of interleukin-6 in resistance to tumor therapy.Discover oncology · 2025Review
- Interim C-reactive protein levels predict the prognosis of patients with metastatic colorectal cancer receiving immunotherapy: a retrospective cohort study.Therapeutic advances in medical oncology · 2025Article
- Exploring HSP90α and hs-CRP using AI models to predict prognosis in advanced hepatocellular carcinoma treated with PD-1 inhibitors and targeted therapy.Frontiers in pharmacology · 2025Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Immunotherapy based on immune checkpoint inhibitors (ICIs) has become the first-line treatment for unresectable hepatocellular carcinoma (uHCC). However, only a small portion of patients are responsive to ICIs. It is important to identify the patients who are likely to benefit from ICIs in clinical practice. We aimed to examine the significance of serum IL-6 and CRP levels in predicting the effectiveness of ICIs for uHCC. Methods: We retrospectively recruited 222 uHCC patients who received ICIs treatment (training cohort: 124 patients, validation cohort: 98 patients). In the training cohort, patients are categorized into the response group (R) and no-response group (NR). The levels of serum IL-6 and CRP were compared between the two groups. Internal validation was performed in the validation cohort. Survival analysis was carried out using the Kaplan-Meier method and Cox proportional hazard regression model. The nomograms were developed and assessed using the consistency index (C-index) and calibration curve. Results: Serum levels of IL-6 and CRP were significantly lower in the R group than in the NR group (9.94 vs. 36.85 pg/ml, p< 0.001; 9.90 vs. 24.50 mg/L, p< 0.001, respectively). An ROC curve was employed to identify the optimal cut-off values for IL-6 and CRP in both groups, resulting in values of 19.82 pg/ml and 15.50 mg/L, respectively. Multivariate Cox regression analysis revealed that MVI (HR 1.751, 95%CI 1.059-2.894, p=0.029; HR 1.530, 95%CI 0.955-2.451, p=0.077), elevated IL-6 (HR 1.624, 95%CI 1.016-2.596, p=0.043; HR 2.146, 95%CI 1.361-3.383, p =0.001) and high CRP (HR 1.709, 95%CI 1.041-2.807, p=0.034; HR 1.846, 95%CI 1.128-3.022, p = 0.015) were independent risk factors for PFS and OS, even after various confounders adjustments. Nomograms are well-structured and validated prognostic maps constructed from three variables, as MVI, IL6 and CRP. Conclusion: Low levels of IL-6 and CRP have a positive correlation with efficacy for uHCC patients receiving ICIs.
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