The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy
Abstract Background Predicting the efficacy of immune-based therapy in patients with unresectable hepatocellular carcinoma (HCC) remains a clinical challenge. This study aims to evaluate the prognostic value of the systemic immune-inflammation index (SII) in forecasting treatment response and surviv...
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BMC
2025-01-01
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| Series: | Biomarker Research |
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| Online Access: | https://doi.org/10.1186/s40364-024-00722-6 |
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| author | Tian He Bin Xu Lu-Na Wang Zi-Yi Wang Huan-Chen Shi Cheng-Jie Zhong Xiao-Dong Zhu Ying-Hao Shen Jian Zhou Jia Fan Hui-Chuan Sun Bo Hu Cheng Huang |
| author_facet | Tian He Bin Xu Lu-Na Wang Zi-Yi Wang Huan-Chen Shi Cheng-Jie Zhong Xiao-Dong Zhu Ying-Hao Shen Jian Zhou Jia Fan Hui-Chuan Sun Bo Hu Cheng Huang |
| author_sort | Tian He |
| collection | DOAJ |
| description | Abstract Background Predicting the efficacy of immune-based therapy in patients with unresectable hepatocellular carcinoma (HCC) remains a clinical challenge. This study aims to evaluate the prognostic value of the systemic immune-inflammation index (SII) in forecasting treatment response and survival outcomes for HCC patients undergoing immune-based therapy. Methods We analyzed a cohort of 268 HCC patients treated with immune-based therapy from January 2019 to March 2023. A training cohort of 93 patients received atezolizumab plus bevacizumab (T + A), while a validation cohort of 175 patients underwent treatment with tyrosine kinase inhibitors (TKIs) combined with anti-PD-(L)1 therapy. The SII cutoff value, determined using X-tile analysis based on overall survival (OS) in the training cohort, divided patients into high (> 752*109) and low (≤ 752*109) SII groups. Prognostic factors were identified through univariate and multivariate logistic and Cox regression analyses, and survival outcomes were assessed using Kaplan–Meier methods. The predictive accuracy of SII was evaluated using receiver operating characteristic (ROC) curves. Results An optimal SII cutoff of 752*109 stratified patients into high and low SII groups. Univariate and multivariate logistic regression indicated that SII was a significant predictor of the objective response rate (ORR), which was markedly different between the low and high SII subgroups (34.72% vs. 9.52%, P = 0.019). This finding was consistent in the validation cohort (34.09% vs. 16.28%, P = 0.026). SII also demonstrated prognostic value in Cox regression and Kaplan–Meier analyses. ROC curves confirmed that SII had superior predictive accuracy compared to common clinical indicators, with predictive relevance even in AFP-negative patients. Furthermore, a lower SII was associated with a higher T cell ratio and an increased number of CD8+ T cells and Granzyme B+ CD8+ T cells in peripheral blood. Conclusion SII is a promising predictor of both therapeutic efficacy and prognosis in HCC patients undergoing immune-based treatments. Its application may enhance clinical decision-making, thereby improving patient outcomes from immune-based therapy. |
| format | Article |
| id | doaj-art-874c252a2a38456696acb5bf679cc4bb |
| institution | Kabale University |
| issn | 2050-7771 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Biomarker Research |
| spelling | doaj-art-874c252a2a38456696acb5bf679cc4bb2025-01-19T12:33:34ZengBMCBiomarker Research2050-77712025-01-0113111310.1186/s40364-024-00722-6The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapyTian He0Bin Xu1Lu-Na Wang2Zi-Yi Wang3Huan-Chen Shi4Cheng-Jie Zhong5Xiao-Dong Zhu6Ying-Hao Shen7Jian Zhou8Jia Fan9Hui-Chuan Sun10Bo Hu11Cheng Huang12Department of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalDepartment of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan HospitalAbstract Background Predicting the efficacy of immune-based therapy in patients with unresectable hepatocellular carcinoma (HCC) remains a clinical challenge. This study aims to evaluate the prognostic value of the systemic immune-inflammation index (SII) in forecasting treatment response and survival outcomes for HCC patients undergoing immune-based therapy. Methods We analyzed a cohort of 268 HCC patients treated with immune-based therapy from January 2019 to March 2023. A training cohort of 93 patients received atezolizumab plus bevacizumab (T + A), while a validation cohort of 175 patients underwent treatment with tyrosine kinase inhibitors (TKIs) combined with anti-PD-(L)1 therapy. The SII cutoff value, determined using X-tile analysis based on overall survival (OS) in the training cohort, divided patients into high (> 752*109) and low (≤ 752*109) SII groups. Prognostic factors were identified through univariate and multivariate logistic and Cox regression analyses, and survival outcomes were assessed using Kaplan–Meier methods. The predictive accuracy of SII was evaluated using receiver operating characteristic (ROC) curves. Results An optimal SII cutoff of 752*109 stratified patients into high and low SII groups. Univariate and multivariate logistic regression indicated that SII was a significant predictor of the objective response rate (ORR), which was markedly different between the low and high SII subgroups (34.72% vs. 9.52%, P = 0.019). This finding was consistent in the validation cohort (34.09% vs. 16.28%, P = 0.026). SII also demonstrated prognostic value in Cox regression and Kaplan–Meier analyses. ROC curves confirmed that SII had superior predictive accuracy compared to common clinical indicators, with predictive relevance even in AFP-negative patients. Furthermore, a lower SII was associated with a higher T cell ratio and an increased number of CD8+ T cells and Granzyme B+ CD8+ T cells in peripheral blood. Conclusion SII is a promising predictor of both therapeutic efficacy and prognosis in HCC patients undergoing immune-based treatments. Its application may enhance clinical decision-making, thereby improving patient outcomes from immune-based therapy.https://doi.org/10.1186/s40364-024-00722-6Hepatocellular carcinomaImmune-based therapyAtezolizumab-bevacizumabSystemic immune-inflammation index (SII)Prognosis |
| spellingShingle | Tian He Bin Xu Lu-Na Wang Zi-Yi Wang Huan-Chen Shi Cheng-Jie Zhong Xiao-Dong Zhu Ying-Hao Shen Jian Zhou Jia Fan Hui-Chuan Sun Bo Hu Cheng Huang The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy Biomarker Research Hepatocellular carcinoma Immune-based therapy Atezolizumab-bevacizumab Systemic immune-inflammation index (SII) Prognosis |
| title | The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy |
| title_full | The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy |
| title_fullStr | The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy |
| title_full_unstemmed | The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy |
| title_short | The prognostic value of systemic immune-inflammation index in patients with unresectable hepatocellular carcinoma treated with immune-based therapy |
| title_sort | prognostic value of systemic immune inflammation index in patients with unresectable hepatocellular carcinoma treated with immune based therapy |
| topic | Hepatocellular carcinoma Immune-based therapy Atezolizumab-bevacizumab Systemic immune-inflammation index (SII) Prognosis |
| url | https://doi.org/10.1186/s40364-024-00722-6 |
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