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Alpha-fetoprotein response after locoregional therapy for hepatocellular carcinoma: oncologic marker of radiologic response, progression, and survival
Journal of Clinical Oncology, 10/08/09

Riaz A et al. – The data presented support the use of AFP response seen after locoregional therapy as an ancillary method of assessing tumor response and survival, as well as an early objective screening tool for progression by imaging.

• 463 patients with HCC treated with chemoembolization or radioembolization
• 125 patients with baseline AFP higher than 200 ng/mL studied for analysis
• AFP response defined as > 50% decrease from baseline
• 119 patients with follow-up imaging studied for AFP imaging correlation analysis
• AFP response correlated to radiologic response, TTP, PFS, and OS
• Multivariate analyses were performed

• 81 patients (65%) showed AFP response
• AFP response seen in 26 (55%) of 47 and 55 (70%) of 78 of patients treated with chemoembolization and radioembolization
• WHO response was seen in 41 (53%) of 77 and 10 (24%) of 42 of AFP responders and nonresponders
• HR for TTP in AFP nonresponders compared with responders was 2.8
• HR for PFS was 4.2 (95% CI, 2.4 to 7.2) in AFP nonresponders compared with responders
• HR for OS in AFP nonresponders compared with responders was 5.5 (95% CI, 3.1 to 9.9) and 2.7 (95% CI, 1.6 to 4.6) on univariate and multivariate analyses

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