ArticleCancer management and research2026
Pre-Treatment HBV Activation Modulates Circulating Immune Markers in Hepatocellular Carcinoma Patients Undergoing TACE Plus ICIs and Anti-VEGF Antibodies/TKIs.
Article in Cancer management and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the impact of pre-treatment hepatitis B virus (HBV) activation on peripheral immune status and treatment response in unresectable hepatocellular carcinoma (uHCC) patients undergoing transarterial chemoembolization (TACE) combined with immune checkpoint inhibitors (ICIs) and anti-vascular endothelial growth factor (anti-VEGF) antibodies or tyrosine kinase inhibitors (TKIs), and to explore the underlying immunological basis. Methods: This single-center retrospective study included uHCC patients treated with TACE plus ICIs and anti-VEGF antibodies or TKIs between July 2019 and September 2024. Patients were categorized into inactive and active HBV infection groups based on pre-treatment HBV DNA levels. A 1:2 propensity score matching (PSM) was used to minimize confounding. The primary outcome was overall survival (OS), and secondary outcomes included progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Peripheral immune markers were assessed at baseline (Cycle0), Cycle2, and Cycle4. Intergroup comparisons and regression analyses were performed to examine associations among HBV activation, immune changes, and objective response (OR). Results: A total of 70 patients were enrolled, and 53 were retained after PSM (26 with inactive and 27 with active HBV infection). Median follow-up was 16.6 months; median OS and PFS were 30.1 and 10.6 months, respectively. At Cycle0, serum IgA levels were higher in the active HBV infection group [3.38 (2.72-4.60) vs 2.70 (2.21-3.32) g/L, Conclusion: Pre-treatment HBV activation is linked to altered baseline immune profiles, particularly elevated IgA, and influences early IgA dynamics. Early IgA changes independently predict early treatment response, supporting the integration of IgA-based immune profiling into personalized strategies for HBV-related uHCC.
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