Modified albumin-bilirubin predicted survival of unresectable hepatocellular carcinoma patients treated with immunotherapy

Table 1 Baseline characteristics of the unresectable hepatocellular carcinoma patients who received atezolizumab plus bevacizumab therapy, n (%)

Variables	Total, n = 83	mALBI 1+2a, n = 42	mALBI 2b+3, n = 41	P value
Age in yr, mean ± SD	60.6 ± 12.8	59.8 ± 14.0	61.5 ± 11.5	0.560
Male	67 (80.7)	34 (81.0)	33 (80.5)	0.960
ECOG-PS				0.680
0	78 (94.0)	40 (95.2)	38 (92.7)
1	5 (6.0)	2 (4.8)	3 (7.3)
Presence of cirrhosis	76 (91.6)	35 (83.3)	41 (100)	< 0.001
CTP A	58 (69.9)	35 (83.3)	23 (56.1)
CTP B	18 (21.7)	0 (0)	18 (43.9)
Etiology of disease
Viral hepatitis	53 (63.9)	27 (64.3)	26 (63.4)	0.930
NASH	23 (27.7)	11 (26.2)	12 (29.3)	0.750
Alcohol related	7 (8.4)	1 (2.4)	6 (14.6)	0.060
Others	1 (1.2)	1 (2.4)	0 (0)	1.000
BCLC staging
BCLC B	22 (26.5)	6 (14.3)	16 (39.0)	0.010
BCLC C	61 (73.5)	36 (85.7)	25 (61.0)
Macrovascular invasion	30 (36.1)	15 (35.7)	15 (36.6)	0.930
Extrahepatic metastasis	40 (48.2)	25 (59.5)	15 (36.6)	0.040
AFP in ng/mL, median (IQR)	339.0 (10.7, 6300.0)	581.5 (11.5, 6869.5)	339.0 (10.5, 9144.5)	0.880
Tumor size in cm, median (IQR)	5.3 (1.7, 12.0)	4.8 (1.7, 11.0)	5.6 (1.7, 14.3)	0.730
Portal vein invasion grade of 2/3/4	8 (26.7)/13 (43.3)/9 (30.0)	4 (26.7)/7 (46.7)/4 (26.7)	4 (26.7)/6 (40.0)/5 (33.3)	1.000
EHM bone/lymph node/lung/peritoneum	11 (27.5)/14 (35.0)/21 (52.5)/9 (22.5)	8 (32.0)/7 (28.0)/13 (52.0)/3 (12.0)	3 (20.0)/7 (46.7)/8 (53.3)/6 (40.0)	0.350
ALBI score, median (IQR)	-2.270 (-2.628 to -1.826)	-2.622 (-2.836 to -2.398)	-1.826 (-2.067 to -1.434)	< 0.001
mALBI grade				< 0.001
1: ≤ -2.60	23 (27.7)	23 (54.8)	0 (0)
2a: > -2.60 to ≤ -2.27	19 (22.9)	19 (45.2)	0 (0)
2b: > -2.27 to ≤ -1.39	32 (38.6)	0 (0)	32 (78.0)
3: > -1.39	9 (10.8)	0 (0)	9 (22.0)
Prior local therapy for HCC	62 (74.7)	33 (78.6)	29 (70.7)	0.410
Resection	22 (35.5)	17 (51.5)	5 (17.2)	0.005
Ablation	17 (27.4)	9 (27.3)	8 (27.6)	0.980
TACE	48 (77.4)	23 (69.7)	25 (86.2)	0.120
TARE	9 (14.5)	5 (15.2)	4 (13.8)	1.000
EBRT	19 (30.6)	11 (33.3)	8 (27.6)	0.620
Prior systemic therapy for HCC	10 (12.0)	4 (9.5)	6 (14.6)	0.460
Sorafenib	5 (50.0)	1 (25.0)	4 (66.7)	0.530
Lenvatinib	4 (40.0)	2 (50.0)	2 (33.3)	1.000
> 2 lines of systemic therapy	2 (20.0)	1 (25.0)	1 (16.7)	1.000
AB as first-line treatment	20 (24.1)	9 (21.4)	11 (26.8)	0.570
Combination of AB and other local therapy as first-line treatment	3 (3.6)	3 (7.1)	0 (0)	0.240
Resection/TACE/TARE/EBRT	0 (0)/0 (0)/0 (0)/3 (100)	0 (0)/0 (0)/0 (0)/3 (100.0)	0 (0)/0 (0)/0 (0)/0 (0)	0.240
Number of AB cycle, median (IQR)	4.0 (2.0, 9.0)	5.0 (4.0, 11.3)	3.0 (1.0, 4.5)	< 0.001

AB: Atezolizumab plus bevacizumab; AFP: Alpha fetoprotein; ALBI: Albumin-bilirubin; BCLC: Barcelona Clinic Liver Cancer; CTP: Child-Turcotte-Pugh; EBRT: External beam radiotherapy; ECOG-PS: Eastern Cooperative Oncology Group Performance Status; EHM: Extrahepatic metastasis; HCC: Hepatocellular carcinoma; IQR: Interquartile range; mALBI: Modified albumin-bilirubin; NASH: Nonalcoholic steatohepatitis; SD: Standard deviation; TACE: Transarterial chemoembolization; TARE: Transarterial radioembolization.