| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Simplified BALAD (BALAD-S) Score as a Guide for First-Line Immune Checkpoint Inhibitor Selection for Unresectable Hepatocellular Carcinoma. |
| 掲載誌名 | 正式名：Hepatology research : the official journal of the Japan Society of Hepatology 略 称：Hepatol Res ISSNコード：13866346/13866346 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Atsushi Hiraoka, Toshifumi Tada, Masashi Hirooka, Kazuya Kariyama, Joji Tani, Masanori Atsukawa, Koichi Takaguchi, Ei Itobayashi, Takashi Nishimura, Kunihiko Tsuji, Toru Ishikawa, Kazuto Tajiri, Hidenori Toyoda, Chikara Ogawa, Takeshi Hatanaka, Satoru Kakizaki, Kazuhito Kawata, Atsushi Naganuma, Hisashi Kosaka, Tomomitsu Matono, Hidekatsu Kuroda, Yutaka Yata, Hiroki Nishikawa, Hironori Tanaka, Michitaka Imai, Tomoko Aoki, Hironori Ochi, Hideyuki Tamai, Shohei Komatsu, Yoshihide Ueda, Soo Ki Kim, Shintaro Takaki, Fujimasa Tada, Hideko Ohama, Shinichiro Nakamura, Takanori Matsuura, Yoshiko Nakamura, Osamu Yoshida, Kazuhiro Nouso, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Akemi Tsutsui, Takuya Nagano, Kazunari Tanaka, Yuichi Koshiyama, Yuki Kanayama, Hidenao Noritake, Jumpei Okamura, Hirayuki Enomoto, Kosuke Matsui, Masaki Kaibori, Tamami Abe, Yoichi Hiasa, Masatoshi Kudo, Takashi Kumada, |
| 発行年月 | 2026/07 |
| 概要 | BACKGROUND AND AIM:Atezolizumab plus bevacizumab (Atez/Bev) and durvalumab plus tremelimumab (Dur/Tre) are widely used first-line immune checkpoint inhibitor (ICI)-based regimens for unresectable hepatocellular carcinoma (uHCC). However, reliable biomarkers to inform treatment choice remain limited. This study evaluated whether the simplified BALAD-based score (BALAD-S) is associated with differential treatment outcomes.MATERIALS AND METHODS:This multicenter retrospective study included 752 Japanese patients with uHCC who received first-line Atez/Bev (n = 645) or Dur/Tre (n = 107) between October 2020 and March 2026. BALAD-S was calculated using bilirubin, albumin, AFP, AFP-L3, and des-γ-carboxy prothrombin, and patients were stratified into BALAD-S low (≤ 2) and high (≥ 3) groups. Treatment response, progression-free survival (PFS), and overall survival (OS) were evaluated.RESULTS:In the BALAD-S low group, Atez/Bev showed longer PFS than Dur/Tre (10.5 vs. 4.3 months; p < 0.001), with longer OS also observed (28.3 vs. 19.4 months; p = 0.049). In the BALAD-S high group, PFS did not differ significantly (7.0 vs. 5.3 months with Dur/Tre and Atez/Bev, respectively, p = 0.210), whereas OS was longer with Dur/Tre than with Atez/Bev (27.3 vs. 16.4 months; p = 0.022). Treatment effects differed by BALAD-S category (HR for Dur/Tre vs. Atez/Bev: 1.50 in BALAD-S low and 0.55 in BALAD-S high; p for interaction = 0.005). In patients treated from 2023 onward, similar treatment-effect heterogeneity was observed (HR 1.61 in BALAD-S low and 0.59 in BALAD-S high; p for interaction = 0.007).CONCLUSION:Outcomes with Atez/Bev and Dur/Tre differed according to BALAD-S score. BALAD-S may help identify patients with differential outcomes between first-line ICI-based regimens and represents a candidate stratification marker requiring validation. |
| DOI | 10.1111/hepr.70239 |
| PMID | 42460702 |