ArticleJournal of hepatocellular carcinoma2026
Validation of the Up7-ALBI Score for Prognostication in Unresectable Hepatocellular Carcinoma Treated with Atezolizumab Plus Bevacizumab.
Article in Journal of hepatocellular carcinoma, 2026. 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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Abstract
Purpose: A well-established prognostic scoring system for unresectable hepatocellular carcinoma (uHCC) receiving systemic therapy is lacking. The Up7-ALBI score has shown prognostic value for lenvatinib. This study aimed to validate its prognostic value in uHCC treated with atezolizumab plus bevacizumab (atezo-bev). Patients and Methods: This retrospective multicenter study included 225 patients with uHCC who received first-line atezo-bev in Taiwan between 2017 and 2025. The Up7-ALBI score (0-2), combining tumor burden (within vs beyond up-to-7) and ALBI grade (1 vs 2-3), categorized patients into low-, intermediate-, and high-risk groups. The score was used to stratify progression-free survival (PFS) and overall survival (OS), with multivariate Cox analysis performed. Prognostic performance was compared with previously reported scoring systems. Results: The objective response rate (ORR) and disease control rate were 44.4% and 60.4%, respectively, and the median PFS and OS were 7.0 and 23.8 months. Among the 225 enrolled patients, 178 patients had complete data for Up7-ALBI analysis. The Up7-ALBI score significantly stratified outcomes, with median OS not reached, 36.0 months, and 9.2 months for scores 0, 1, and 2 (p < 0.01); median PFS of 13.4, 7.9, and 5.8 months (p < 0.01); and ORR of 66.7%, 52.2%, and 32.9%, respectively (p < 0.01). Multivariate analysis showed that Up7-ALBI scores 1 and 2, along with macrovascular invasion, were independent risk factors for OS. The Up7-ALBI score demonstrated the lowest Akaike information criterion (484.3) among the previously proposed scores. Conclusion: This study validated the Up7-ALBI score for uHCC receiving atezo-bev. Its consistent prognostic performance across systemic therapies supports its potential as a simple, clinically applicable risk-stratification tool.
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