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Title: Effect of ramucirumab on ALBI grade in patients with advanced HCC: Results from REACH and REACH-2
Author: Kudo, Masatoshi
Galle, Peter R.
Brandi, Giovanni
Kang, Yoon Koo
Yen, Chia Jui
Finn, Richard S.
Llovet i Bayer, Josep Maria
Assenat, Eric
Merle, Philippe
Chan, Stephen L.
Palmer, Daniel H.
Ikeda, Masafumi
Yamashita, Tatsuya
Vogel, Arndt
Huang, Yi Hsiang
Abada, Paolo
Yoshikawa, Reigetsu
Shinozaki, Kenta
Wang, Chunxiao
Widau, Ryan C.
Zhu, Andrew X.
Keywords: Nomografia (Matemàtica)
Càncer de fetge
Nomography (Mathematics)
Liver cancer
Issue Date: 13-Nov-2020
Publisher: Elsevier
Abstract: Background & Aims: The albumin-bilirubin (ALBI) grade/score is derived from a validated nomogram to objectively assess prognosis and liver function in patients with hepatocellular carcinoma (HCC). In this post hoc analysis, we assessed prognosis in terms of survival by baseline ALBI grade and monitored liver function during treatment with ramucirumab or placebo using the ALBI score in patients with advanced HCC. Methods: Patients with advanced HCC, Child-Pugh class A with prior sorafenib treatment were randomised in REACH trials to receive ramucirumab 8 mg/kg or placebo every 2weeks. Datawere analysed by trial and as a meta-analysis of individual patientlevel data (pooled population) from REACH (alpha-fetoprotein>− 400 ng/ml) and REACH-2. Patients from REACHwith Child-Pugh class Bwere analysed as a separate cohort. The ALBI grades and scoreswere calculated at baseline and before each treatment cycle. Results: Baseline characteristics by ALBI grade were balanced between treatment arms among patients in the pooled population (ALBI-1, n = 231; ALBI-2, n = 296; ALBI-3, n = 7). Baseline ALBI grade was prognostic for overall survival (OS; ALBI grade 2 vs. 1; hazard ratio [HR]: 1.38 [1.13-1.69]), after adjusting for other significant prognostic factors. Mean ALBI scores remained stable in both treatment arms compared with baseline and were unaffected by baseline ALBI grade, macrovascular invasion, tumour response, geographical region, or prior locoregional therapy. Baseline ALBI grades 2 and 3 were associated with increased incidence of liver-specific adverse events and discontinuation rates in both treatments. Ramucirumab improved OS in patients with baseline ALBI grade 1 (HR 0.605 [0.445-0.824]) and ALBI grade 2 (HR 0.814 [0.630-1.051]. Conclusions: Compared with placebo, ramucirumab did not negatively impact liver function and improved survival irrespective of baseline ALBI grade.
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It is part of: JHEP Reports, 2020, vol. 3, num. 2, p. 100215
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ISSN: 2589-5559
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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