Serum osteopontin levels predicts response to treatment in unresectable HCC

Among patients with unresectable hepatocellular carcinoma (HCC) scheduled to receive standard combination therapy with atezolizumab plus bevacizumab, those with high levels of serum osteopontin at baseline are likely to have poor response to treatment, as shown in a study.

For the study, researchers enrolled 70 patients with unresectable HCC treated with atezolizumab plus bevacizumab and 62 patients treated with lenvatinib or healthy volunteers (control). Blood samples were collected before and after 1 and 6 weeks of therapy. These samples were used to analyse the concentrations of 47 circulating proteins using a multiplex bead-based immunoassay and ELISA. Results of the serum analysis in patients and in controls were compared.

The disease control rate was 77.1 percent, and the median progression-free survival (PFS) was 5.7 months (95 percent confidence interval [CI], 3.8–9.5).

Before treatment, the levels of osteopontin, angiopoietin-2, VEGF, S100–calcium-binding protein A8/S100–calcium-binding protein A9, soluble programmed cell death-1, soluble CD163, and 14 cytokines/chemokines were all higher in patients with unresectable HCC than in healthy volunteers.

Of the circulating proteins assessed prior to treatment, osteopontin levels were higher among patients with progressive disease than among those without progressive disease in the group who received treatment with atezolizumab plus bevacizumab.

Likewise, the rate of progressive disease was greater in the group of patients with high vs low osteopontin levels.

On multivariate analysis, high pretreatment osteopontin and α‐fetoprotein levels emerged as independent predictors of progressive disease.

In a subgroup analysis that included patients with Child–Pugh class A, PFS was also shorter among those with high vs low pretreatment osteopontin levels.

Finally, pretreatment osteopontin showed no association with treatment response for lenvatinib.