Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC

BackgroundSeveral serum cytokines have been proposed as biomarkers for predicting the outcomes of patients with hepatocellular carcinoma (HCC) receiving tyrosine kinase inhibitors. However, their role in atezolizumab plus bevacizumab (AB) treatment needs to be more elucidated.MethodsWe examined vari...

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Main Authors: Hee Sun Cho, Soon Kyu Lee, Ji Won Han, Jung Hyun Kwon, Soon Woo Nam, Jaejun Lee, Keungmo Yang, Pil Soo Sung, Jeong Won Jang, Seung Kew Yoon, Jong Young Choi
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1578422/full
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author Hee Sun Cho
Hee Sun Cho
Hee Sun Cho
Soon Kyu Lee
Soon Kyu Lee
Ji Won Han
Ji Won Han
Jung Hyun Kwon
Jung Hyun Kwon
Soon Woo Nam
Soon Woo Nam
Jaejun Lee
Jaejun Lee
Keungmo Yang
Keungmo Yang
Pil Soo Sung
Pil Soo Sung
Jeong Won Jang
Jeong Won Jang
Seung Kew Yoon
Seung Kew Yoon
Jong Young Choi
Jong Young Choi
author_facet Hee Sun Cho
Hee Sun Cho
Hee Sun Cho
Soon Kyu Lee
Soon Kyu Lee
Ji Won Han
Ji Won Han
Jung Hyun Kwon
Jung Hyun Kwon
Soon Woo Nam
Soon Woo Nam
Jaejun Lee
Jaejun Lee
Keungmo Yang
Keungmo Yang
Pil Soo Sung
Pil Soo Sung
Jeong Won Jang
Jeong Won Jang
Seung Kew Yoon
Seung Kew Yoon
Jong Young Choi
Jong Young Choi
author_sort Hee Sun Cho
collection DOAJ
description BackgroundSeveral serum cytokines have been proposed as biomarkers for predicting the outcomes of patients with hepatocellular carcinoma (HCC) receiving tyrosine kinase inhibitors. However, their role in atezolizumab plus bevacizumab (AB) treatment needs to be more elucidated.MethodsWe examined various serum cytokines, including interferon-γ (IFN-γ), interleukin-10 (IL-10), IL-12, IL-17, IL-2, IL-6, and tumor necrosis factor, using a Luminex cytokine multiplex assay before AB treatment in prospectively enrolled 116 AB-treatment patients for the derivation cohort and 54 patients for the external validation cohort. We collected baseline characteristics, including neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels, and prospectively observed clinical outcomes.ResultsAmong various peripheral blood inflammatory markers, high NLR, CRP, IL-2, and IL-12 levels were significantly associated with poor progression-free survival (PFS) and overall survival (OS) in patients with AB-treated HCC. Through sensitivity analysis, we defined the high peripheral blood inflammatory score (PBIS) group, which included two or more of the following elevated factors: NLR, CRP, IL-2, and IL-12. The high PBIS group had elevated serum inflammatory cytokines and a higher tumor burden than the low PBIS group. A high PBIS score was an independent risk factor associated with poor OS, PFS, and objective response rate (ORR) in multivariate analyses, which was also confirmed in the validation cohort and propensity score-matched cohort. However, it was not a significant factor for OS, PFS, or ORR in lenvatinib-treated patients.ConclusionThese results suggest that a peripheral blood marker-based scoring system can significantly predict clinical outcomes in patients with AB-treated HCC. This non-invasive biomarker is expected to be a potential predictive and prognostic factor for AB treatment.
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spelling doaj-art-db873b848cd141a0b80336c11f34d6392025-08-20T03:46:21ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-06-011610.3389/fimmu.2025.15784221578422Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCCHee Sun Cho0Hee Sun Cho1Hee Sun Cho2Soon Kyu Lee3Soon Kyu Lee4Ji Won Han5Ji Won Han6Jung Hyun Kwon7Jung Hyun Kwon8Soon Woo Nam9Soon Woo Nam10Jaejun Lee11Jaejun Lee12Keungmo Yang13Keungmo Yang14Pil Soo Sung15Pil Soo Sung16Jeong Won Jang17Jeong Won Jang18Seung Kew Yoon19Seung Kew Yoon20Jong Young Choi21Jong Young Choi22The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaThe Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Internal Medicine, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of KoreaBackgroundSeveral serum cytokines have been proposed as biomarkers for predicting the outcomes of patients with hepatocellular carcinoma (HCC) receiving tyrosine kinase inhibitors. However, their role in atezolizumab plus bevacizumab (AB) treatment needs to be more elucidated.MethodsWe examined various serum cytokines, including interferon-γ (IFN-γ), interleukin-10 (IL-10), IL-12, IL-17, IL-2, IL-6, and tumor necrosis factor, using a Luminex cytokine multiplex assay before AB treatment in prospectively enrolled 116 AB-treatment patients for the derivation cohort and 54 patients for the external validation cohort. We collected baseline characteristics, including neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) levels, and prospectively observed clinical outcomes.ResultsAmong various peripheral blood inflammatory markers, high NLR, CRP, IL-2, and IL-12 levels were significantly associated with poor progression-free survival (PFS) and overall survival (OS) in patients with AB-treated HCC. Through sensitivity analysis, we defined the high peripheral blood inflammatory score (PBIS) group, which included two or more of the following elevated factors: NLR, CRP, IL-2, and IL-12. The high PBIS group had elevated serum inflammatory cytokines and a higher tumor burden than the low PBIS group. A high PBIS score was an independent risk factor associated with poor OS, PFS, and objective response rate (ORR) in multivariate analyses, which was also confirmed in the validation cohort and propensity score-matched cohort. However, it was not a significant factor for OS, PFS, or ORR in lenvatinib-treated patients.ConclusionThese results suggest that a peripheral blood marker-based scoring system can significantly predict clinical outcomes in patients with AB-treated HCC. This non-invasive biomarker is expected to be a potential predictive and prognostic factor for AB treatment.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1578422/fullhepatocellular carcinomaatezolizumab plus bevacizumabprognostic scorebiomarkercytokine
spellingShingle Hee Sun Cho
Hee Sun Cho
Hee Sun Cho
Soon Kyu Lee
Soon Kyu Lee
Ji Won Han
Ji Won Han
Jung Hyun Kwon
Jung Hyun Kwon
Soon Woo Nam
Soon Woo Nam
Jaejun Lee
Jaejun Lee
Keungmo Yang
Keungmo Yang
Pil Soo Sung
Pil Soo Sung
Jeong Won Jang
Jeong Won Jang
Seung Kew Yoon
Seung Kew Yoon
Jong Young Choi
Jong Young Choi
Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC
Frontiers in Immunology
hepatocellular carcinoma
atezolizumab plus bevacizumab
prognostic score
biomarker
cytokine
title Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC
title_full Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC
title_fullStr Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC
title_full_unstemmed Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC
title_short Peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab-bevacizumab for unresectable HCC
title_sort peripheral blood inflammatory score using a cytokine multiplex assay predicts clinical outcomes in patients treated with atezolizumab bevacizumab for unresectable hcc
topic hepatocellular carcinoma
atezolizumab plus bevacizumab
prognostic score
biomarker
cytokine
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1578422/full
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