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Immune-related adverse events (irAEs) clinically resemble autoimmune diseases, indicating autoantibodies could be potential biomarkers for the prediction of irAEs. This study aimed to assess the predictive value of peripheral blood antinuclear antibody (ANA) status for irAEs, considering the time and severity of irAEs, as well as treatment outcome in liver cancer patients administered anti-PD-1 therapy. Ninety-three patients with advanced primary liver cancer administered anti-PD-1 treatment were analyzed retrospectively. They were divided into the ANA positive (ANA+, titer ≥ 1:100) and negative (ANA-, titer < 1:100) groups. Development of irAEs, progression-free survival (PFS), and overall survival (OS) were assessed. Compared with ANA- patients, ANA+ cases were more prone to develop irAEs (43.3% vs. 19.2%, P = 0.031). With the increase of ANA titers, the frequency of irAEs increased. The time interval between anti-PD-1 therapy and the onset of irAEs was significantly shorter in ANA+ patients compared with the ANA- group (median, 1.7 months vs. 5.0 months, P = 0.022). Moreover, the time between anti-PD-1 therapy and irAE occurrence decreased with increasing ANA titer. In addition, PFS and OS were decreased in ANA+ patients compared with the ANA− group (median PFS, 2.8 months vs. 4.2 months, P = 0.043; median OS, 21.1 months vs. not reached, P = 0.041). IrAEs occur at higher frequency in ANA+ liver cancer patients undergoing anti-PD-1 therapy. ANA titer could help predict irAE development and treatment outcome in these patients. Immune-related adverse events (irAEs) occur at higher frequency in ANA+ liver cancer patients undergoing anti-PD-1 therapy. [ABSTRACT FROM AUTHOR]

Purpose: To assess the efficacy and safety of different peri-operative regimens using the network meta-analysis for hepatocellular carcinoma (HCC) with portal/hepatic vein tumor thrombosis. The interested modalities included neoadjuvant three-dimensional radiotherapy (3D-CRT), post-operative intensity modulated radiation therapy (IMRT), post-operative transarterial chemoembolization (TACE), 3DCRT plus TACE and surgery alone., Methods: PubMed and Cochrane Library electronic databases were systematically searched for eligible studies published up to March 2021. Data related to treatment efficacy including overall survival (OS) and disease-free survival (DFS) were extracted and compared using a Bayesian approach. Adverse events (AEs) were assessed and compared., Results: Five studies published between 2009 and 2021 were enrolled in this network meta-analysis. The comparison showed that surgery with IMRT ranks relatively higher in prolonging OS in advanced HCC patients, followed by neoadjuvant 3DCRT and surgery plus TACE. Neoadjuvant 3DCRT and postoperative IMRT appear to be better choices than 3DCRT plus TACE in terms of OS. IMRT, TACE and neoadjuvant 3DCRT group were all superior to surgery alone in terms of DFS. The rate of AEs did not differ significantly., Conclusions: Adjuvant IMRT showed more favorable treatment responses compared to other regimens in HCC patients as a peri-operative regimen.

Purpose: To assess the efficacy and safety of different perioperative regimens using network meta-analysis for hepatocellular carcinoma (HCC) with hepatic/portal vein thrombosis. The interested modalities included neoadjuvant three-dimensional conformal radiotherapy (3D-CRT), post-operative intensity modulated radiation therapy (IMRT). post-operative transarterial chemoembolization (TACE) and surgery alone., Methods: PubMed and Cochrane Library electronic databases were systematically searched for eligible studies published up to November 2020. Data related to treatment efficacy including overall survival (OS), and disease-free survival (DFS) were extracted and compared using a Bayesian approach. Adverse events (AEs) were assessed and compared., Results: Four studies published between 2005 and 2020 involving a total of 422 patients were enrolled in this network meta-analysis. The comparison showed that surgery with IMRT ranked relatively higher in prolonging OS in advanced HCC patients, followed by neoadjuvant 3DCRT and surgery plus TACE. Postoperative IMRT appeared better choice in terms of DFS. The rate of AEs did not significantly differ., Conclusion: Adjuvant IMRT showed more favorable treatment responses compared with other regimens in HCC patients with hepatic/portal vein thrombosis.