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Early changes in immunoglobulin G levels during immune checkpoint inhibitor treatment are associated with survival in hepatocellular carcinoma patients

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Listed:
  • Lorenz Balcar
  • David Bauer
  • Katharina Pomej
  • Tobias Meischl
  • Mattias Mandorfer
  • Thomas Reiberger
  • Michael Trauner
  • Bernhard Scheiner
  • Matthias Pinter

Abstract

Background & aims: Immunotherapy represents the new standard of care in systemic first-line treatment of hepatocellular carcinoma (HCC). Biomarkers that predict treatment response and survival remain an unmet clinical need. Methods: Patients with HCC treated with immune-checkpoint inhibitors (ICI) between 10/2017 and 03/2022 were retrospectively evaluated. Immunoglobulin levels (IgG, IgM, IgA) were measured at baseline and six weeks after initiation of ICI treatment. Impact of relative changes on overall survival (OS), progression-free survival (PFS), and time to progression (TTP) were evaluated. Results: Seventy-two patients with HCC receiving ICI (mostly atezolizumab/bevacizumab n = 54,75%) were included (mean age: 68±12 years, cirrhosis: 72%, mean Child-Turcotte-Pugh [CTP] score: 7±2 points). Most patients had a preserved performance status (ECOG-PS 0, n = 45, 63%), 25 (35%) showed macrovascular invasion, and 32 (44%) had extrahepatic spread. Conclusion: Our study proposes a higher increase of Δ-IgG upon ICI treatment as a negative prognostic marker in patients with HCC, independent of underlying liver disease severity. These results require independent validation.

Suggested Citation

  • Lorenz Balcar & David Bauer & Katharina Pomej & Tobias Meischl & Mattias Mandorfer & Thomas Reiberger & Michael Trauner & Bernhard Scheiner & Matthias Pinter, 2023. "Early changes in immunoglobulin G levels during immune checkpoint inhibitor treatment are associated with survival in hepatocellular carcinoma patients," PLOS ONE, Public Library of Science, vol. 18(4), pages 1-11, April.
    • Handle: RePEc:plo:pone00:0282680
    DOI: 10.1371/journal.pone.0282680
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