ArticleJournal of hepatocellular carcinoma2025
Early PIVKA-II Response Associated with Treatment Efficacy and Survival Outcomes for Patients with Advanced Hepatocellular Carcinoma Receiving Immune Checkpoint Inhibitors and Targeted Therapy.
Article in Journal of hepatocellular carcinoma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Development and validation of a personalized web-based calculator of aggressive recurrence after surgery for early-stage hepatocellular carcinoma by machine learning.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: Prothrombin induced by vitamin K absence-II (PIVKA-II) levels have been reported to correlate with hepatocellular carcinoma (HCC) prognosis, but its utility for assessing early treatment response remains underexplored. This study evaluated early PIVKA-II changes for predicting response and survival in HCC patients undergoing immune checkpoint inhibitors (ICIs) and targeted therapy. Methods: Eighty-two HCC patients were enrolled. Serum PIVKA-II levels were measured at baseline and after the first treatment cycle. Patients were stratified based on early PIVKA-II dynamics into a biochemical response group (≥50% reduction, n=40) and a non-response group (<50% reduction, n=42). Logistic regression and Cox proportional hazards models were used to identify predictors of objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results: Time-dependent ROC analysis established ≥50% PIVKA-II decline as the early response threshold. The PIVKA-II response group had a significantly higher proportion of patients with Child-Pugh A, a lower incidence of extrahepatic metastasis, and significantly higher ORR (82.5% vs 38.1%, P<0.001). Median PFS and OS were not reached in the PIVKA-II responder group, compared to 8.9 months and 16.7 months, respectively, in the non-responder group (both P < 0.001). Multivariate analysis confirmed early PIVKA-II response as an independent predictor of PFS (HR=0.687, P<0.001) and OS (HR=0.709, P<0.001). Notably, in AFP-negative patients, an early PIVKA-II response was predictive of ORR and was associated with significantly longer PFS and OS. Conclusion: Early PIVKA-II response effectively predicts treatment response and prognosis in advanced HCC patients receiving ICI and targeted therapy, especially in AFP-negative patients.
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