Evidence map›Paper›PMID 39840727›Full record

ArticleCancer medicine2025

Evaluation of Treatment Outcomes Using dNLR and GNRI in Combination Therapy With Atezolizumab and Bevacizumab for Hepatocellular Carcinoma.

Atsushi Naganuma, Satoru Kakizaki, Atsushi Hiraoka, Toshifumi Tada, Takeshi Hatanaka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi and 33 more

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Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

43 authors.

Atsushi NaganumaDepartment of Gastroenterology, NHO Takasaki General Medical Center, Takasaki, Japan.ORCID https://orcid.org/0000-0003-0663-0102
Satoru KakizakiDepartment of Clinical Research, NHO Takasaki General Medical Center, Takasaki, Japan.ORCID https://orcid.org/0000-0003-0224-7093
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
Takeshi HatanakaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.ORCID https://orcid.org/0000-0003-3656-285X
Kazuya KariyamaDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.ORCID https://orcid.org/0000-0003-3996-7502
Joji TaniDepartment of Gastroenterology and Neurology, Kagawa University, Kita-gun, Japan.
Masanori AtsukawaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.ORCID https://orcid.org/0000-0003-3374-7111
Koichi TakaguchiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.ORCID https://orcid.org/0000-0003-0175-8721
Ei ItobayashiDepartment of Gastroenterology, Asahi General Hospital, Asahi, Japan.ORCID https://orcid.org/0000-0003-0475-2819
Shinya FukunishiDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Japan.
Kunihiko TsujiCenter of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.ORCID https://orcid.org/0009-0007-4152-9364
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
Hidenori ToyodaDepartment of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.ORCID https://orcid.org/0000-0002-1652-6168
Chikara OgawaDepartment of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Takamatsu, Japan.
Hiroki NishikawaDepartment of Gastroenterology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Takashi NishimuraDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Japan.ORCID https://orcid.org/0000-0002-5517-8303
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 Hepatobiliary Surgery, Kansai Medical University, Hirakata, Japan.ORCID https://orcid.org/0000-0002-2926-9973
Masashi HirookaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan.
Yutaka YataDepartment of Gastroenterology, Hanwa Memorial Hospital, Osaka, Japan.ORCID https://orcid.org/0000-0002-4592-3509
Hideko OhamaDepartment of Gastroenterology, Takarazuka City Hospital, Takarazuka, Japan.ORCID https://orcid.org/0000-0002-1882-824X
Hidekatsu KurodaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.ORCID https://orcid.org/0000-0002-1471-1087
Tomomitsu MatonoDepartment of Gastroenterology, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Japan.
Tomoko AokiDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
Yuki KanayamaDepartment of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan.
Kazunari TanakaCenter of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Fujimasa TadaGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.ORCID https://orcid.org/0009-0007-3964-5876
Kazuhiro NousoDepartment of Gastroenterology, Okayama City Hospital, Okayama, Japan.ORCID https://orcid.org/0000-0002-2018-0008
Asahiro MorishitaDepartment of Gastroenterology and Neurology, Kagawa University, Kita-gun, Japan.ORCID https://orcid.org/0000-0002-0760-3045
Akemi TsutsuiDepartment of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.ORCID https://orcid.org/0000-0003-2978-2723
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.
Shinichiro NakamuraDepartment of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.
Hirayuki EnomotoDivision of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Nishinomiya, Japan.
Masaki KaiboriDepartment of Hepatobiliary Surgery, Kansai Medical University, Hirakata, Japan.ORCID https://orcid.org/0000-0002-0577-3921
Yoichi HiasaDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan.ORCID https://orcid.org/0000-0003-4117-339X
Masatoshi KudoDepartment of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.ORCID https://orcid.org/0000-0002-4102-3474
Takashi KumadaGifu Kyoritsu University, Ogaki, Japan.ORCID https://orcid.org/0000-0003-2211-495X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThis study aims to investigate the clinical utility of the derived neutrophil-to-lymphocyte ratio (dNLR) and the Geriatric Nutritional Risk Index (GNRI) in predicting treatment outcomes for patients with unresectable hepatocellular carcinoma (HCC) undergoing combination therapy with atezolizumab and bevacizumab (Atez/Bev).

methodsA retrospective analysis was conducted on 310 patients. The dNLR, NLR, and GNRI were calculated, and their impact on progression-free survival (PFS) and overall survival (OS) was assessed. The formula for calculating dNLR is: (neutrophil count ÷ [white blood cell count-neutrophil count]), which means it does not require lymphocyte count. Furthermore, GNRI-dNLR and GNRI-NLR scores were defined, and their prognostic values were also analyzed.

resultsThe median PFS of this cohort was 7.2 months (95% CI: 5.9-8.5), and the median OS was 24.9 months (95% CI: 19.6-30.2). The dNLR, NLR, and GNRI were significant predictors of both PFS and OS. The dNLR showed a significant correlation with the NLR (Pearson correlation coefficient, p < 0.0001). Patients with high GNRI-dNLR scores demonstrated significantly worse PFS and OS compared to those with low scores (p = 0.001, p < 0.001, respectively). Compared to stratification by GNRI alone, the GNRI-dNLR or GNRI-NLR provided better stratification for both PFS and OS.

conclusionThe dNLR could be a valuable substitute for NLR as a prognostic marker in patients with unresectable HCC undergoing Atez/Bev therapy. It offers a feasible alternative for databases lacking lymphocyte count information, ensuring comprehensive patient stratification and outcome prediction. The GNRI-NLR or GNRI-dNLR score provided better stratification compared to GNRI alone.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBevacizumabCarcinoma, HepatocellularLiver NeoplasmsLymphocytesNeutrophilsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedFemaleHumansLeukocyte CountLymphocyte CountMaleMiddle AgedAntibodies, Monoclonal, HumanizedatezolizumabBevacizumabdNLRGNRIhepatocellular carcinomaimmune checkpoint inhibitorprognosis

Identifiers

PMID39840727
PMCPMC11751879

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