Diagnostics
Treatment-Stratified Immune–Inflammatory Trajectories and Early Response in Patients with Hepatocellular Carcinoma Receiving Systemic Therapy
By Ashley Kim, Manaf Alsudaney, Osama Khattab and 12 others.
Abstract
Background
Systemic therapy outcomes in hepatocellular carcinoma (HCC) remain heterogeneous, and treatment selection is still largely guided by clinical eligibility rather than dynamic biologic response. We evaluated whether accessible standard-of-care immunophenotypic and immune–inflammatory markers, tumor-marker kinetics, and immune-context variables could generate treatment-stratified early response signals.
Methods
We conducted a retrospective analysis of 153 unique patients with HCC, each contributing one systemic therapy episode. First on-treatment imaging response was classified as complete response, partial response, stable disease, or progressive disease. Routine immune-cell indices, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and systemic immune-inflammation index (SII), were evaluated at baseline and early post-treatment timepoints. Alpha-fetoprotein (AFP) kinetics and overall survival were analyzed descriptively.