Changes in systemic immune‑infammation index (SII) predict the prognosis of patients with hepatitis B‑related hepatocellular carcinoma treated with lenvatinib plus PD‑1 inhibitors

• Yang Yao ^[1] ; Minyue Zhang ^[1] ; Di Liu ^[1] ; Xiaoni Liu ^[2] ; Quanwei Li ^[1]
  1. [1] Department of Integrated Traditional Chinese and Western Medicine, Beijing Youan Hospital, Capital Medical University, No. 8 Xi Tou Tiao, You An Men Wai, Feng Tai District, Beijing 100069, China
  2. [2] Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, No. 8 Xi Tou Tiao, You An Men Wai, Feng Tai District, Beijing 100069, China
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 27, Nº. 3, 2025, págs. 1155-1165
• Idioma: inglés
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• Resumen

  • Purpose This study aimed to evaluate the prognostic signifcance of changes in infammatory markers in patients with Hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) treated with frst-line lenvatinib plus a programmed cell death protein 1 (PD-1) inhibitor.

    Methods This study retrospectively included 117 HBV-HCC patients treated with frst-line lenvatinib in combination with a PD-1 inhibitor. Independent factors afecting progression-free survival (PFS) and overall survival (OS) were explored based on baseline indicators and infammatory markers changes after one treatment cycle.

    Results Multivariate analysis revealed that an alpha-fetoprotein (AFP) level ⩾400 ng/mL [hazard ratio (HR), 1.69; 95% confdence interval (CI), 1.11–2.58; P = 0.01] was identifed as an independent risk factor, platelet-to-neutrophil ratio (PNR) ⩽ 65.43 (HR 0.50; 95% CI 0.30–0.84; P < 0.01) and SII ⩽539.47 (HR 0.54; 95% CI 0.30–0.96; P = 0.03) were identifed as independent protective factors for PFS. Additionally, multivariate analysis demonstrated that AFP ⩾ 400 ng/mL, HBV-HCC patients with diabetes mellitus (DM), and SII > 303.66 were independent risk factors of OS. The patients whose SII had increased after one cycle of treatment showed a poorer PFS (HR 1.61; 95 %CI 1.10–2.37; P = 0.015) and OS (HR 1.76; 95 % CI 1.15–2.70; P = 0.009) than patients whose SII had decreased. The objective response rate (ORR) was higher in the SII-decreased patients (47.5% vs 32.5%, P = 0.11). Mann–Whitney test found a signifcant diference in therapeutic response between the SII-increased patients and the SII-decreased patients (P = 0.04).

    Conclusion SII can be associated with outcomes in patients with HBV-HCC treated with frst-line lenvatinib plus PD-1 inhibitors.