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. 2024 Mar 1;24(1):281.
doi: 10.1186/s12885-024-12040-z.

LABS score- a prognostic tool for FOLFOX4-treated advanced hepatocellular carcinoma and real-world efficacy: a single-center retrospective study

Jirapat Wonglhow  1 , Patrapim Sunpaweravong  1 , Chirawadee Sathitruangsak  1 , Arunee Dechaphunkul  2
Affiliations

LABS score- a prognostic tool for FOLFOX4-treated advanced hepatocellular carcinoma and real-world efficacy: a single-center retrospective study

Jirapat Wonglhow et al. BMC Cancer. .

Abstract

Background: No widely used prognostic tool exists to demonstrate the benefit of oxaliplatin plus 5-fluorouracil/leucovorin (FOLFOX4) in patients with advanced hepatocellular carcinoma (HCC). We aimed to establish a prognostic score and demonstrate the real-world efficacy of FOLFOX4 chemotherapy in Thai patients.

Methods: Between August 2017 and December 2021, we identified 58 FOLFOX4-treated patients with HCC. Overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were assessed. The prognostic score was constructed by stepwise Cox proportional hazards regression analysis to select variables for the best model with the lowest Akaike information criterion from all potential variables.

Results: Forty-four patients (76%) received FOLFOX4 as first-line therapy. The ORR in the entire cohort was 8.6%, and the disease control rate was 29.3%. The PFS and OS were 3.7 and 4.8 months, respectively. Four clinically relevant variables were included in the new prognostic score to predict 6-month OS: L, the presence of lung metastasis; A, alcoholic cirrhosis; B, elevated total bilirubin level; and S, sorafenib-naïve status. Using the LABS score, patients were classified into low-, intermediate-, and high-risk groups, demonstrating OS values of 9.3, 4.2, and 2.1 months, respectively (p < 0.0001). The C-index and area under the receiver-operating characteristic curve of the score were 0.71 and 0.73, respectively.

Conclusions: The proposed LABS score could discriminate patients who would derive benefit from FOLFOX4 chemotherapy. FOLFOX4 chemotherapy is an option for patients who cannot receive immunotherapy and targeted therapy, particularly those with a low-risk score. However, further validation of this model via larger cohorts is warranted.

Keywords: Chemotherapy; FOLFOX; Hepatocellular carcinoma; Liver cancer; Prognostic score.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Area under receiver-operating characteristic curve of LABS score
Fig. 2
Fig. 2
Kaplan-Meier curve of stratified survival based on the LABS score in FOLFOX4-treated patients with advanced hepatocellular carcinoma
Fig. 3
Fig. 3
Overall survival (A) for entire cohort (B) by line of treatment
Fig. 4
Fig. 4
Progression-free survival (A) for entire cohort (B) by line of treatment
See this image and copyright information in PMC

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