Background Immunotherapy is widely used in patients with hepatocellular carcinoma (HCC), but it is necessary to search for effective prognostic markers to provide personalized and precise treatment.
Objective To investigate the relationship between antigen presenting cell (APC) subsets and immunotherapy efficacy in HCC patients.
Methods Prospectively, advanced HCC patients receiving initial immunotherapy at the Fifth Medical Center of Chinese PLA General Hospital were enrolled from May 2022 to September 2023, blood was collected before immunotherapy, and the antigen presenting cell (APC) were detected by flow cytometry technology. The patients were divided into high and low groups according to the mean value, and the progression free survival (PFS) between the two groups was compared, and the factors affecting PFS were analyzed by Cox regression analysis. Finally, the ROC curve was used to predict the effectiveness of disease control.
Results A total of 84 participants were enrolled, with a median age of 57 years. There were 58 male patients and 26 female patients. The baseline data of APC showed that the mean B/LYM was 16.54% ± 6.27%, the mean MA/TNC was 9.14% ± 2.87%, and the mean DC/TNC was 0.051% ± 0.021%. Kaplan-Meier survival analysis and Cox regression analysis showed that mPFS in the high B/LYM group was significantly higher than that in the low group (5.90 months vs 5.50 months, P=0.019; HR=0.588, 95% CI: 0.358-0.966), mPFS in the low MA/TNC group was significantly higher than that in the high group (7.20 months vs 5.40 months, P=0.034; HR=0.617, 95% CI: 0.374-1.019), mPFS in DC/TNC patients of high group was significantly higher than that in the low group (6.30 months vs 5.50 months, P=0.026; HR=0.615, 95% CI: 0.378-0.955). High level of MA/TNC was an independent risk factors for disease progression, while high levels of DC/TNC and B/LYM were protective factors for disease progression. Baseline B/LYM, MA/TNC, and DC/TNC showed good predictive efficacy for disease control in HCC patients after 2 cycles of treatment, and the efficacy was further improved when they were in combination, with AUC of 0.685, 0.723, 0.745, and 0.865 respectively.
Conclusion HCC patients with high levels of DC/TNC, B/LYM, and low level of MA/TNC may be more likely to benefit from immunotherapy.
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