Abstract
Purpose: Alpha-fetoprotein (AFP) is considered to be an indicator of tumor activity in hepatocellular carcinoma (HCC). We present a novel correlation of AFP response to radiologic response, time-to-progression (TTP), progression-free survival (PFS), and overall survival (OS) in patients treated with locoregional therapies. Patients and Methods: Four hundred sixty-three patients with HCC were treated with chemoembolization or radioembolization at our institution. One hundred twenty-five patients with baseline AFP higher than 200 ng/mL were studied for this analysis. AFP response was defined as more than 50% decrease from baseline. One hundred nineteen patients with follow-up imaging were studied for the AFP imaging correlation analysis. AFP response was correlated to radiologic response, TTP, PFS, and OS. Multivariate analyses were performed. Results: Eighty-one patients (65%) showed AFP response. AFP response was seen in 26 (55%) of 47 and 55 (70%) of 78 of patients treated with chemoembolization and radioembolization, respectively (P = .12). WHO response was seen in 41 (53%) of 77 and 10 (24%) of 42 of AFP responders and nonresponders, respectively (P = .002). The hazard ratio (HR) for TTP in AFP nonresponders compared with responders was 2.8 (95% CI, 1.5 to 5.1). The HR for PFS was 4.2 (95% CI, 2.4 to 7.2) in AFP nonresponders compared with responders. The HR for OS in AFP nonresponders compared with responders was 5.5 (95% CI, 3.1 to 9.9) and 2.7 (95% CI, 1.6 to 4.6) on univariate and multivariate analyses, respectively. Conclusion: The data presented support the use of AFP response seen after locoregional therapy as an ancillary method of assessing tumor response and survival, as well as an early objective screening tool for progression by imaging.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 5734-5742 |
| Number of pages | 9 |
| Journal | Journal of Clinical Oncology |
| Volume | 27 |
| Issue number | 34 |
| DOIs | |
| State | Published - Dec 1 2009 |
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ASJC Scopus subject areas
- Oncology
- Cancer Research
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Alpha-fetoprotein response after locoregional therapy for hepatocellular carcinoma : Oncologic marker of radiologic response, progression, and survival. / Riaz, Ahsun; Ryu, Robert K.; Kulik, Laura M.; Mulcahy, Mary F.; Lewandowski, Robert J.; Minocha, Jeet; Ibrahim, Saad M.; Sato, Kent T.; Baker, Talia; Miller, Frank H.; Newman, Steven; Omary, Reed; Abecassis, Michael; Benson, Al B.; Salem, Riad.
In: Journal of Clinical Oncology, Vol. 27, No. 34, 01.12.2009, p. 5734-5742.Research output: Contribution to journal › Article
TY - JOUR
T1 - Alpha-fetoprotein response after locoregional therapy for hepatocellular carcinoma
T2 - Oncologic marker of radiologic response, progression, and survival
AU - Riaz, Ahsun
AU - Ryu, Robert K.
AU - Kulik, Laura M.
AU - Mulcahy, Mary F.
AU - Lewandowski, Robert J.
AU - Minocha, Jeet
AU - Ibrahim, Saad M.
AU - Sato, Kent T.
AU - Baker, Talia
AU - Miller, Frank H.
AU - Newman, Steven
AU - Omary, Reed
AU - Abecassis, Michael
AU - Benson, Al B.
AU - Salem, Riad
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Purpose: Alpha-fetoprotein (AFP) is considered to be an indicator of tumor activity in hepatocellular carcinoma (HCC). We present a novel correlation of AFP response to radiologic response, time-to-progression (TTP), progression-free survival (PFS), and overall survival (OS) in patients treated with locoregional therapies. Patients and Methods: Four hundred sixty-three patients with HCC were treated with chemoembolization or radioembolization at our institution. One hundred twenty-five patients with baseline AFP higher than 200 ng/mL were studied for this analysis. AFP response was defined as more than 50% decrease from baseline. One hundred nineteen patients with follow-up imaging were studied for the AFP imaging correlation analysis. AFP response was correlated to radiologic response, TTP, PFS, and OS. Multivariate analyses were performed. Results: Eighty-one patients (65%) showed AFP response. AFP response was seen in 26 (55%) of 47 and 55 (70%) of 78 of patients treated with chemoembolization and radioembolization, respectively (P = .12). WHO response was seen in 41 (53%) of 77 and 10 (24%) of 42 of AFP responders and nonresponders, respectively (P = .002). The hazard ratio (HR) for TTP in AFP nonresponders compared with responders was 2.8 (95% CI, 1.5 to 5.1). The HR for PFS was 4.2 (95% CI, 2.4 to 7.2) in AFP nonresponders compared with responders. The HR for OS in AFP nonresponders compared with responders was 5.5 (95% CI, 3.1 to 9.9) and 2.7 (95% CI, 1.6 to 4.6) on univariate and multivariate analyses, respectively. Conclusion: The data presented support the use of AFP response seen after locoregional therapy as an ancillary method of assessing tumor response and survival, as well as an early objective screening tool for progression by imaging.
AB - Purpose: Alpha-fetoprotein (AFP) is considered to be an indicator of tumor activity in hepatocellular carcinoma (HCC). We present a novel correlation of AFP response to radiologic response, time-to-progression (TTP), progression-free survival (PFS), and overall survival (OS) in patients treated with locoregional therapies. Patients and Methods: Four hundred sixty-three patients with HCC were treated with chemoembolization or radioembolization at our institution. One hundred twenty-five patients with baseline AFP higher than 200 ng/mL were studied for this analysis. AFP response was defined as more than 50% decrease from baseline. One hundred nineteen patients with follow-up imaging were studied for the AFP imaging correlation analysis. AFP response was correlated to radiologic response, TTP, PFS, and OS. Multivariate analyses were performed. Results: Eighty-one patients (65%) showed AFP response. AFP response was seen in 26 (55%) of 47 and 55 (70%) of 78 of patients treated with chemoembolization and radioembolization, respectively (P = .12). WHO response was seen in 41 (53%) of 77 and 10 (24%) of 42 of AFP responders and nonresponders, respectively (P = .002). The hazard ratio (HR) for TTP in AFP nonresponders compared with responders was 2.8 (95% CI, 1.5 to 5.1). The HR for PFS was 4.2 (95% CI, 2.4 to 7.2) in AFP nonresponders compared with responders. The HR for OS in AFP nonresponders compared with responders was 5.5 (95% CI, 3.1 to 9.9) and 2.7 (95% CI, 1.6 to 4.6) on univariate and multivariate analyses, respectively. Conclusion: The data presented support the use of AFP response seen after locoregional therapy as an ancillary method of assessing tumor response and survival, as well as an early objective screening tool for progression by imaging.
UR - http://www.scopus.com/inward/record.url?scp=73349142702&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=73349142702&partnerID=8YFLogxK
U2 - 10.1200/JCO.2009.23.1282
DO - 10.1200/JCO.2009.23.1282
M3 - Article
C2 - 19805671
AN - SCOPUS:73349142702
VL - 27
SP - 5734
EP - 5742
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 34
ER -