Nutrition and metabolism status alteration in advanced hepatocellular carcinoma patients treated with anti-PD-1 immunoth
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ORIGINAL ARTICLE
Nutrition and metabolism status alteration in advanced hepatocellular carcinoma patients treated with anti-PD-1 immunotherapy Yizhen Jiang 1,2 & Xiaoxuan Tu 1 & Xiangying Zhang 1 & Haihong Liao 2 & Shuwen Han 2 & Weiqin Jiang 1 & Yi Zheng 1 & Peng Zhao 1 & Zhou Tong 1 & Qihan Fu 1 & Quan Qi 2 & Junjun Shen 2 & Liping Zhong 2 & Yuefen Pan 2 & Weijia Fang 1 Received: 23 October 2019 / Accepted: 17 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this study was to evaluate the nutrition and metabolism status alteration during immunotherapy in advanced hepatocellular carcinoma (HCC) patients. Methods Patients with advanced HCC who participated in the clinical trials of single-agent anti-PD-1 immunotherapy or sorafenib were retrospectively included. We analyzed self-comparison of the nutritional and metabolic indices of patients in the anti-PD-1 and sorafenib treatment group. We conducted mutual-comparison of the mentioned indices between the disease progression group and disease control group among anti-PD-1 treatment patients. We further analyzed those indices with statistical differences by partial correlation and survival analysis. Results Both self-comparison before and after treatment in the anti-PD-1 group and mutual-comparison of disease progression and the control group showed significant differences in multiple indices, but we did not observe significant differences in the sorafenib group. Strikingly, albumin (ALB)/prognostic nutritional index (PNI, calculated by serum albumin and lymphocyte count) decreased distinctly in the immunotherapy disease progression group patients. However, changes in ALB/PNI were not significant in disease progression patients from the sorafenib group or in the disease control patients with immunotherapy. Partial correlation analysis suggested that ALB and PNI were positively correlated with the efficacy of immunotherapy. Furthermore, survival analysis showed that the median progression-free survival and median overall survival of patients in the ALB/PNI decreased group were significantly shorter than those of patients from the ALB/PNI increased group. Conclusion Anti-PD-1 immunotherapy might alter the nutritional and metabolic status in advanced HCC patients. We also should pay attention to the nutritional and metabolic status of patients when drug resistance is detected. Keywords Nutrition and metabolism . Albumin . Prognostic nutritional index . Hepatocellular carcinoma . Anti-PD-1 immunotherapy
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00520-020-05478-x) contains supplementary material, which is available to authorized users. * Yuefen Pan [email protected] * Weijia Fang [email protected] 1
Department of Medical Oncology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, People’s Republic of China
2
Department of Medical Oncology, Huzhou Central Hospital, Huzhou 313000, Zhejiang, People’s Republic of China
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