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- Title
The GALAD score and the BALAD-2 score correlate with transarterial and systemic treatment response and survival in patients with hepatocellular carcinoma.
- Authors
Olbrich, Anne; Niemeyer, Johannes; Seiffert, Hendrik; Ebel, Sebastian; Gros, Olga; Lordick, Florian; Forstmeyer, Dirk; Seehofer, Daniel; Rademacher, Sebastian; Denecke, Timm; Matz-Soja, Madlen; Berg, Thomas; van Bömmel, Florian
- Abstract
Purpose: The GALAD score and the BALAD-2 score are biomarker-based scoring systems used to detect hepatocellular carcinoma (HCC). Both incorporate levels of alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP). Our objective was to examine the relationship between the GALAD score as well as the BALAD-2 score and treatment response to transarterial or systemic treatments in patients with HCC. Methods: A total of 220 patients with HCC treated with either transarterial (n = 121) or systemic treatments (n = 99; mainly Sorafenib) were retrospectively analyzed. The GALAD score and the BALAD-2 score were calculated based on AFP-L3, AFP, and DCP levels measured in serum samples collected before treatment. The results were correlated with 3-month treatment efficacy based on radiologic mRECIST criteria. Results: The GALAD score showed a strong correlation with BCLC stage (p < 0.001) and total tumor diameter before treatment (p < 0.001).The GALAD score at baseline was significantly lower in patients with a 3-month response to transarterial (p > 0.001) than in refractory patients. Among patients receiving systemic treatment, the median BALAD-2 score at baseline showed a strong association with response at month 3 (p < 0.001). In the transarterial treatment group, the GALAD score (AUC = 0.715; p < 0.001) as well as the BALAD score (AUC = 0.696; p < 0.001) were associated with overall survival, hereby outperforming AFP, AFP-L3 and DCP. Conclusion: The GALAD score as well as the BALAD-2 score hold significant promise as a prognostic tool for patients with early or intermediate-stage HCC who are undergoing transarterial or systemic treatments.Highlights: The GALAD score is associated with response of HCC to transarterial treatments. The BALAD-2 score is associated with response of HCC to systemic treatments. The GALAD score is also associated with response in HCC patients with AFP levels ≤ 20 ng/mL. The GALAD score as well as the BALAD-2 score at baseline correlate with overall survival in patients who received transarterial therapy.
- Publication
Journal of Cancer Research & Clinical Oncology, 2024, Vol 150, Issue 2, p1
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-023-05526-z