Alpha-fetoprotein Response Evaluation:A Clinical Study Of Sorafenib Combined With Camrelizumab In The Treatment Of Advanced Hepatic Malignancies

Objective:To investigate the clinical efficacy and safety of Alpha-fetoprotein response in sorafenib(Sorafenib)in combination with carrelizumab(Carrelizumab)for the treatment of advanced hepatocellular carcinoma.Methods: Clinical data of 48 patients with advanced hepatic malignancies treated with Sorafenib combined with Carrelizumab at the First Affiliated Hospital of Xinjiang Medical University from 2020-9 to 2022-2were selected and grouped according to post-treatment alpha-fetoprotein(AFP)response level: response group(AFP reduction rate >20% compared with basal AFP at 6-8 months of treatment);In the non response group(AFP decreased by less than or equal to 20%compared with the basic AFP during 6-8 months of treatment),The results of progression-free survival(PFS),overall survival(OS),and therapeutic effect were compared between the two groups.Results: Forty-eight patients with complete clinical data and eligible for this treatment protocol were treated in combination,including 32 in the response group and 16 in the non response group.None of the follow-up patients were lost or discontinued due to adverse effects or intolerance of treatment.No patient in either group achieved clinical remission(CR).Partial remission(PR)in the AFP early responder group and partial remission(PR)in the AFP non-responder group were 7 cases(26.92%)vs 0 cases,and stable disease(SD)was 20 cases(61.54%)vs 7 cases(43.75%),respectively,with the responder group being higher than the non-responder group.Disease progression(PD)was 5 cases(34.62%)vs.9 cases(56.75%),respectively,with the AFP responder group being lower than the non-responder group.Objective effective rate(ORR)was 26.92% vs 0(P<0.05)and disease control rate(DCR)was 71.88% vs 43.75%(P<0.05),respectively,higher in the responder group than in the non-responder group.Progression-free survival(PFS)of 9.9 months and overall survival(OS)of 13.8 months were higher in the responder group than in the non-responder group(6.8 months,11.1months).Early non-response to alpha-fetoprotein(AFP)(HR=2.624,95% CI=1.097-6.277,P=0.030)and extrahepatic metastasis(HR=0.392,95% CI=0.157-0.978,P=0.045)were independently associated with shorter progression-free survival(PFS).No discontinuation events due to adverse reactions in the study.Conclusion: Early response to AFP is of high clinical value in predicting the efficacy and prognosis of patients with advanced hepatocellular carcinoma treated with Sorafenib in combination with Carrelizumab...