Baseline Host Biomarkers and Six-Month Sustained Drug-Free Status After Atezolizumab–Bevacizumab for Hepatocellular Carcinoma: Exploratory Clinical Stratification Using PAN-DF Score

Background/Objectives: Sustained drug-free status is an emerging milestone after atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma. We examined baseline host biomarkers associated with achievement of 6-month sustained drug-free status and evaluated a composite stratification score.

Methods

This multicentre retrospective study included patients treated with atezolizumab plus bevacizumab. The endpoint required systemic therapy discontinuation after complete response or no viable disease, followed by at least 6 months without viable or recurrent hepatocellular carcinoma and sustained normalization of initially elevated tumour markers. The PAN-DF score (preserved hepatic reserve, altered immune-inflammatory status, and nutritional-immune reserve for achieving drug-free status) combined modified albumin–bilirubin grade, neutrophil-to-lymphocyte ratio, and prognostic nutritional index.