Changes in serum α-fetoprotein level predicts treatment response and survival in hepatocellular carcinoma patients and literature review.

Abstract

BACKGROUND:

Oxaliplatin-based chemotherapy is an alternative systemic treatment for patients with metastatic hepatocellular carcinoma (HCC) who were refractory or intolerant to sorafenib. To date, there have been no biomarkers reported to monitor the therapeutic efficacy and to predict the outcomes of HCC patients receiving oxaliplatin-based chemotherapy.

METHODS:

Eighty-one HCC patients with elevated baseline α-fetoprotein (AFP) levels and extrahepatic spreading who received oxaliplatin-based chemotherapy between 2012 and 2014 were retrospectively enrolled in this study. Two AFP tests were performed, at baseline and 2-4 weeks after the initiation of chemotherapy. The change in AFP levels was calculated for survival analysis.

RESULTS:

In the AFP decline group (decreased compared to baseline), the median progression-free survival (PFS) and overall survival (OS) were 7.0 months and 12.3 months, respectively. In the AFP nondecline group, the median PFS and OS were 2.3 months and 3.0 months, respectively. The difference in OS between the two groups was significant (p < 0.005). In the multivariate analysis for disease progression, the best response to chemotherapy and AFP decline were independent factors, with p values of 0.004 and 0.009, respectively. In the multivariate analysis for OS, the baseline Child-Pugh score, best response to chemotherapy, and AFP decline were independent prognostic factors, with p values of 0.01, 0.001, and 0.008, respectively. Additionally, the unit change in AFP level was predictive of PFS and OS with p values of 0.007 and 0.001, respectively.

CONCLUSION:

The change in AFP levels 2-4 weeks after initiating oxaliplatin-based chemotherapy is useful to predict treatment response and survival.

• Authors: Wen-Chi Chou, Chia-Lin Lee, Tsai-Sheng Yang, Chen-Yang Huang, Wei Teng, Ya-Ting Tseng, Jen-Shi Chen, Yung-Chang Lin, Ming-Mo Hou, Ho-Hsiang Chang, Jason Chia-Hsun Hsieh
• Journal: Journal of the Formosan Medical Association = Taiwan yi zhi (J Formos Med Assoc) Vol. 117 Issue 2 Pg. 153-163 (Feb 2018) ISSN: 0929-6646 [Print] Singapore
• PMID: 28392193 (Publication Type: Journal Article)
• Copyright: Copyright © 2017. Published by Elsevier B.V.

Chemical References

• Antineoplastic Agents
• Biomarkers, Tumor
• Organoplatinum Compounds
• Phenylurea Compounds
• alpha-Fetoproteins
• Oxaliplatin
• Niacinamide
• Sorafenib

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Biomarkers, Tumor (blood)
• Carcinoma, Hepatocellular (blood, drug therapy, mortality)
• Disease Progression
• Female
• Humans
• Liver Neoplasms (blood, drug therapy, mortality)
• Male
• Middle Aged
• Multivariate Analysis
• Niacinamide (analogs & derivatives, therapeutic use)
• Organoplatinum Compounds (therapeutic use)
• Oxaliplatin
• Phenylurea Compounds (therapeutic use)
• Retrospective Studies
• Severity of Illness Index
• Sorafenib
• Survival Analysis
• Taiwan
• Time Factors
• Treatment Outcome
• alpha-Fetoproteins (analysis)