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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1474456
This article is part of the Research Topic Hepatocellular Carcinoma: From Bench to Bedside View all 3 articles

The CRAFITY score emerges as a paramount prognostic indicator in hepatocellular carcinoma patients received Lenvatinib and Pembrolizumab

Provisionally accepted
Weijie Wu Weijie Wu 1,2,3*Zhenyun Yang Zhenyun Yang 1,2,3Hao Zou Hao Zou 1,2,3Teng Long Teng Long 1,2,3Zhongguo Zhou Zhongguo Zhou 1,2,3Yaojun Zhang Yaojun Zhang 1,2,3Minshan Chen Minshan Chen 1,2,3Dandan Hu Dandan Hu 1,2,3
  • 1 Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
  • 2 Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
  • 3 Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China

The final, formatted version of the article will be published soon.

    Background: Levels of C-reactive protein (CRP) and alpha-fetoprotein (AFP) in immunotherapy (CRAFITY) scores are associated with the prognosis of patients with hepatocellular carcinoma (HCC). This study aimed to explore the efficacy of lenvatinib and pembrolizumab (Len-P) based on the CRAFITY score.Methods: In this study, 228 patients with HCC who received Len-P in Sun Yat-sen University Cancer Center were included. CRAFITY 0 score was defined as AFP level below 100 ng/ml, CRP level below 1 mg/dl, CRAFITY 1 score was defined as AFP level at least 100 ng/ml or CRP level at least 1 mg/dl. CRAFITY 2 scores were defined as AFP levels exceeding 100 ng/ml and CRP levels exceeding 100 ng/ml. The primary outcome was overall survival (OS). The second outcome was tumor response rate.The survival time of CRAFITY 0 is significantly longer than that of CRAFITY 1 and CRAFITY 2 (p =.044). Univariate analysis showed that largest tumor size (HR = 2.149; 95% CI 1.129 -4.091; p =.02), lymph node metastasis (HR = 2.012; 95% CI 1.132-3.579; p = .017), and CRAFITY (HR = 0.372; 95% CI 0.168-0.824; p = .015) were important risk determinants of OS in all patients. The results of multivariate analysis show that CRAFITY score is an independent risk factors for OS (HR = 0.719; 95% CI 0.377-1.374; p =.048). The ORR of CRAFITY 0, 1 and 2 scores were 36.4%, 32% and 27.4%, respectively (p = .556). The ORR of intrahepatic lesions by CRAFITY 0, 1 and 2 were 37.9%, 35%, 30.6% (p= .688).CRAFITY score is a good predictor of prognosis in HCC patients receiving Len-P.

    Keywords: Hepatocellular Carcinoma, Lenvatinib, Pembrolizumab, C-Reactive Protein, a-fetoprotein

    Received: 01 Aug 2024; Accepted: 11 Oct 2024.

    Copyright: © 2024 Wu, Yang, Zou, Long, Zhou, Zhang, Chen and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Weijie Wu, Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.