Z Gastroenterol 2023; 61(05): e195-e196
DOI: 10.1055/s-0043-1769051
Abstracts | ÖGGH
POSTER
Hepatologie

Validation of the CRAFITY score in patients with hepatocellular carcinoma treated with atezolizumab and bevacizumab

B. Scheiner
1   Medical University of Vienna, Vienna, Austria
,
R. Sartoris
2   APHP.Nord, Hôpital Beaujon, Clichy, France
,
A. D'Alessio
3   Imperial College London, London, United Kingdom
,
C. A. Fulgenzi
3   Imperial College London, London, United Kingdom
,
K. Pomej
1   Medical University of Vienna, Vienna, Austria
,
L. Balcar
1   Medical University of Vienna, Vienna, Austria
,
M. Bouattour
2   APHP.Nord, Hôpital Beaujon, Clichy, France
,
S. Sidali
2   APHP.Nord, Hôpital Beaujon, Clichy, France
,
V. Himmelsbach
4   University Hospital Frankfurt, Frankfurt, Germany
,
F. Finkelmeier
4   University Hospital Frankfurt, Frankfurt, Germany
,
K. Schulze
5   University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
J. von Felden
5   University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
F. Hucke
6   Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria
,
K. Shmanko
7   University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
,
A. R. Siebenhüner
8   University Hospital Zurich, Zurich, Switzerland
,
J. C. Mertens
8   University Hospital Zurich, Zurich, Switzerland
,
S. De Dosso
9   Ente Ospedaliero Cantonale, Bellinzona, Switzerland
,
N. N. Rahbari
10   Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
,
M. P. Ebert
10   Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
,
A. Teufel
10   Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
,
D. Waldschmidt
11   University of Cologne, Cologne, Germany
,
P. Radu
12   Inselspital Bern, Bern, Switzerland
,
A. Krall
13   Medical University of Graz, Graz, Austria
,
M. Trauner
1   Medical University of Vienna, Vienna, Austria
,
J. Dufour
14   Centre for digestive diseases, Lausanne, Switzerland
,
H. Wege
15   Cancer Center Esslingen, Esslingen am Neckar, Germany
,
A. Weinmann
7   University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
,
J. Trojan
4   University Hospital Frankfurt, Frankfurt, Germany
,
R. Stauber
13   Medical University of Graz, Graz, Austria
,
M. Peck-Radosavljevic
6   Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria
,
W. Hsu
16   China Medical University Hospital, Taichung, Taiwan
,
A. Vogel
17   Hannover Medical School, Hannover, Germany.
,
M. Ronot
2   APHP.Nord, Hôpital Beaujon, Clichy, France
,
D. J. Pinato
3   Imperial College London, London, United Kingdom
,
M. Pinter
1   Medical University of Vienna, Vienna, Austria
› Author Affiliations
› Further Information
Also available ateRef
 
 

    Background  We recently developed the CRP and AFP in Immunotherapy (CRAFITY) score in patients with HCC undergoing immune checkpoint inhibitor (ICI) therapy. As CRAFITY was developed in patients undergoing different ICI-based regimens, the score requires validation in patients treated with atezolizumab and bevacizumab (AB).

    Method  AB-treated patients with HCC at 15 centers in Europe and Asia between 12/2018-01/2023 were included. CRAFITY was derived from serum CRP and AFP values prior to AB initiation by adding one point each for CRP ≥1mg/dL and AFP ≥100ng/mL resulting in the following categories: 0 points  = CRAFITY-low, 1 point  = CRAFITY-intermediate, 2 points  = CRAFITY-high.

    Results  Overall, 274 patients (66.1±11.0 years; male: n=224, 82%) were included. While 97 patients (35%) had CRAFITY-low, n=113 (41%) and n=64 (23%) had CRAFITY-intermediate and CRAFITY-high, respectively. Median OS and PFS were significantly worse in patients with higher CRAFITY scores (OS: low:23.4 (95%CI:14.8-32.0) vs. intermediate:15.9 (95%CI:11.9-19.9) vs. high:8.6 (95%CI:5.6-11.6) months, p<0.001; PFS: low:11.1 (95%CI:9.3-12.9) vs. intermediate:6.5 (95%CI:5.0-8.1) vs. high:3.2 (95%CI:2.7-3.7) months, p<0.001). Upon multivariable analyses, CRAFITY was independently associated with OS (aHR: intermediate vs. low:1.51 (95%CI:0.92-2.48), p=0.103; high vs. low:2.56 (95%CI:1.52-4.33), p<0.001) as well as PFS (aHR: intermediate vs. low:1.77 (95%CI:1.21-2.59), p=0.003; high vs. low:2.90 (95%CI:1.91-4.39), p<0.001).

    CRAFITY was also significantly associated with radiological response (complete/partial response (CR/PR) / stable disease (SD) / progressive disease (PD), which was evaluable in 245 patients (89%): low:n=34 (38%)/n=45 (50%)/n=11 (12%) vs. intermediate:n=37 (37%)/n=28 (28%)/n=34 (34%) vs. high:n=12 (21%)/n=18 (32%)/n=26 (46%); p<0.001). Disease control rates (DCR) were 88% vs. 66% vs. 54% (p<0.001), respectively. Upon multivariable logistic regression, a higher CRAFITY score was independently associated with a lower probability of disease control (aOR: intermediate vs. low:0.25 (95%CI:0.11-0.55), p=0.001; high vs. low:0.15 (95%CI:0.06-0.35), p<0.001).

    Conclusion  The CRAFITY score identifies AB treated patients with a favourable prognosis and response and may help with patient counselling.


     

    Publication History

    Article published online:
    24 May 2023

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