ALBI Grade Analyses of TACE Combined with Anti-Angiogenesis Therapies Plus PD-1 Inhibitors versus Anti-Angiogenesis Therapies Plus PD-1 Inhibitors in Advanced HCC

Xin Hong,1,* Di Hu,2,* Wen-Jie Zhou,3,* Xiu-De Wang,4 Li-Hua Huang,5 Tian-An Huang,1 Yi-Wei Guan,1 Jingyu Qian,6 Wen-Bin Ding1 1Department of Interventional Radiology, Affiliated Hospital 2 of Nantong University, Nantong, People’s Republic of China; 2Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 3Department of Interventional Radiology, Northern Jiangsu People’s Hospital, Clinical Medical College of Yangzhou University, Yangzhou, People’s Republic of China; 4Department of Interventional Radiology, Nantong Second People’s Hospital, Nantong, People’s Republic of China; 5Department of Interventional Radiology, Nantong Haimen District People’s Hospital, Nantong, People’s Republic of China; 6Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wen-Bin Ding, Department of Interventional Radiology, Affiliated Hospital 2 of Nantong University, Nantong, 226001, People’s Republic of China, Tel/Fax +86 15951302169, Email [email protected] Jingyu Qian, Department of Interventional Radiology, the First Affiliated Hospital of Bengbu Medical University, Bengbu, 233004, People’s Republic of China, Tel/Fax +86 13004081388, Email [email protected]: To evaluate the baseline albumin-bilirubin (ALBI) grade’s role in advanced hepatocellular carcinoma (HCC) receiving transarterial chemoembolization (TACE) plus anti-angiogenesis therapies and PD-1 inhibitors (TACE+TP) versus anti-angiogenesis therapies and PD-1 inhibitors (TP).Methods: This multicenter retrospective study enrolled advanced HCC undergoing TACE+TP or TP from January 2019 to June 2023 at three hospitals in China. The primary outcomes were time to progression of the ALBI grade and change in ALBI score between the initial baseline and the final assessment point available, the secondary outcomes consisted of overall survival (OS) as well as progression-free survival (PFS).Results: One hundred and eighty-three patients were ultimately enrolled in this study for analysis, of whom 44 were categorized as having an ALBI grade 1 (TACE+TP, n = 23; TP, n = 21) and 139 were classified as ALBI grade 2 (n = 77; n = 62). Time to progression of the ALBI grade, indicating liver function deterioration, was comparable between the TACE+TP and TP groups (median, 11.2 vs 19.3 months; P = 0.353). Change in ALBI score between the initial baseline and the final assessment point available was comparable among the two groups (difference in least squares mean, 0.084). Irrespective of the initial ALBI grade, patients in TACE+TP group exhibited a significant enhancement in OS and displayed a promising trend towards better PFS.Conclusion: TACE+TP had no negative influence on liver function and enhanced survival regardless of baseline ALBI grade when compared to TP in advanced HCC patients.Keywords: albumin-bilirubin grade, hepatocellular carcinoma, TACE, anti-angiogenesis therapies, PD-1 inhibitors