Hassan, R., Farid, K., Hasson, A., El-Eraky, A. (2025). Dynamic changes of systemic inflammatory markers and their association with radiologic progression and hepatotoxicity in patients with hepatocellular carcinoma on systemic therapy. Medical Journal of Viral Hepatitis, 9.1(1), 1-7. doi: 10.21608/mjvh.2025.417919
Riham Hassan; Khaled Farid; Amany Hasson; Ahmed Mosaad El-Eraky. "Dynamic changes of systemic inflammatory markers and their association with radiologic progression and hepatotoxicity in patients with hepatocellular carcinoma on systemic therapy". Medical Journal of Viral Hepatitis, 9.1, 1, 2025, 1-7. doi: 10.21608/mjvh.2025.417919
Hassan, R., Farid, K., Hasson, A., El-Eraky, A. (2025). 'Dynamic changes of systemic inflammatory markers and their association with radiologic progression and hepatotoxicity in patients with hepatocellular carcinoma on systemic therapy', Medical Journal of Viral Hepatitis, 9.1(1), pp. 1-7. doi: 10.21608/mjvh.2025.417919
Hassan, R., Farid, K., Hasson, A., El-Eraky, A. Dynamic changes of systemic inflammatory markers and their association with radiologic progression and hepatotoxicity in patients with hepatocellular carcinoma on systemic therapy. Medical Journal of Viral Hepatitis, 2025; 9.1(1): 1-7. doi: 10.21608/mjvh.2025.417919
Dynamic changes of systemic inflammatory markers and their association with radiologic progression and hepatotoxicity in patients with hepatocellular carcinoma on systemic therapy
Tropical Medicine dept., Faculty of Medicine, Mansoura Univ., Egypt.
Abstract
Background: Previous studies reported that inflammatory biomarkers could play a prognostic role in patients with unresectable hepatocellular Carcinoma (HCC) treated with sorafenib therapy, but there are no enough studies on new generations of systemic therapy. Objectives: The aim of this study was to evaluate dynamic changes of systemic inflamma-tory markers in patients with unresectable HCC on systemic therapy and to investigate their association with tumor behavior, drug hepatotoxic side effects and overall survival. Subjects and methods: This prospective study was carried out on 235 patients with unresectable HCC. Patients were divided into three groups based on type of systemic therapy: sorafenib group, atezolizumab-bevacizumab group, sequential TKI group (patients who received sorafenib then were shifted to regorafenib). CBC was followed up every month and the foll-owing ratios neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR), monocyte count/lymphocyte count (MLR) and systemic inflammatory response index (SIRI) were calculated and analyzed. Results: A statistically sign-ificant increase in median MLR among Atezo-Bev group after 4 months (p=0.007) was observed, while among sorafenib group; MLR values increase significantly at 4, 8, 12 months (p < 0.001, 0.05, 0.029 respectively). SIRI decreases after 4 months within sequential TKI group (p=0.006) and after 20 months within sorafenib group (p=0.006). PLR was higher among cases with radiologic progression than those without in sorafenib group (P= 0.006), while within Atezo-Bev group; higher NLR was associated with radiologic progression (P= 0.024). Moreover, NLR was higher in patients who develop hepatotoxic side effects due to sorafenib, atezolizumab-bevacizumab (P= 0.04, 0.012 respectively). Conclusion: Systemic inflammatory response markers may offer prognostic value for an optimized selection of patients with HCC who may benefit more from systemic therapy
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