{ "abstract": "Background/Objectives: Sustained drug-free status is an emerging milestone after atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma. We examined baseline host biomarkers associated with achievement of 6-month sustained drug-free status and evaluated a composite stratification score. Methods: This multicentre retrospective study included patients treated with atezolizumab plus bevacizumab. The endpoint required systemic therapy discontinuation after complete response or no viable disease, followed by at least 6 months without viable or recurrent hepatocellular carcinoma and sustained normalization of initially elevated tumour markers. The PAN-DF score (preserved hepatic reserve, altered immune-inflammatory status, and nutritional-immune reserve for achieving drug-free status) combined modified albumin–bilirubin grade, neutrophil-to-lymphocyte ratio, and prognostic nutritional index. Results: Among 655 patients, 25 achieved the endpoint; median post-discontinuation follow-up was 533 days. In the complete-case cohort (n = 473; 17 events), achievement rates were 0.0%, 2.9%, 3.7%, and 13.6% for scores 0–3. Each one-point increase was associated with higher odds of achievement (odds ratio 2.90, 95% confidence interval 1.51–5.55; p = 0.001), and the area under the curve was 0.719. The examined baseline tumour-related factors were not significantly associated with the primary endpoint, and the examined host-related factors were not associated with objective response. Conclusions: Selected baseline host biomarkers were associated with achievement of 6-month sustained drug-free status. PAN-DF stratified the observed probability of this outcome and may help identify patient groups with a relatively higher likelihood of a sustained drug-free state, supporting early multidisciplinary planning.", "abstract_shown": true, "affiliations": [ "Department of Gastroenterology, Hematology and Clinical Immunology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Aomori, Japan", "Department of Gastroenterology and Hepatology, Division of Internal Medicine, Iwate Medical University, Yahaba 028-3694, Iwate, Japan", "Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori 030-8553, Aomori, Japan", "Department of Gastroenterology, Japanese Red Cross Morioka Hospital, Morioka 020-8560, Iwate, Japan", "Division of Gastroenterology, Tohoku University Hospital, Sendai 980-8574, Miyagi, Japan", "Department of Gastroenterology, Akita University Graduate School of Medicine, Akita 010-8543, Akita, Japan", "Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Fukushima, Japan", "Department of Gastroenterology, National Hospital Organization Sendai Medical Center, Sendai 983-8520, Miyagi, Japan", "Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata 990-9585, Yamagata, Japan", "Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Hokkaido, Japan", "Department of Gastroenterology, Hakodate City Hospital, Hakodate 041-8680, Hokkaido, Japan", "Department of Gastroenterology and Hepatology, Japan Community Health Care Organization (JCHO) Hokkaido Hospital, Sapporo 062-8618, Hokkaido, Japan", "Department of Gastroenterology, Hokkaido Gastroenterology Hospital, Sapporo 065-0041, Hokkaido, Japan" ], "article_type": "research article", "arxiv": null, "author_total": 27, "authors": [ { "affs": [ 0 ], "name": "Chikara Iino" }, { "affs": [ 1 ], "name": "Tamami Abe" }, { "affs": [ 1 ], "name": "Kei Endo" }, { "affs": [ 1 ], "name": "Yudai Fujiwara" }, { "affs": [ 0 ], "name": "Kenta Yoshida", "orcid": "0000-0002-3897-5546" }, { "affs": [ 0 ], "name": "Satoshi Sato", "orcid": "0000-0001-5569-7093" }, { "affs": [ 2 ], "name": "Hiroshi Numao" }, { "affs": [ 2 ], "name": "Go Igarashi" }, { "affs": [ 3 ], "name": "Takayoshi Oikawa", "orcid": "0000-0002-1100-6980" }, { "affs": [ 4 ], "name": "Masashi Ninomiya" }, { "affs": [ 4 ], "name": "Mio Tsuruoka" }, { "affs": [ 5 ], "name": "Wataru Sato" }, { "affs": [ 5 ], "name": "Shinichiro Minami", "orcid": "0009-0008-8735-291X" }, { "affs": [ 6 ], "name": "Kazumichi Abe", "orcid": "0000-0001-5359-9465" }, { "affs": [ 6 ], "name": "Masashi Fujita" }, { "affs": [ 7 ], "name": "Nobukazu Tanabe" }, { "affs": [ 8 ], "name": "Tomohiro Katsumi", "orcid": "0000-0001-5670-7505" }, { "affs": [ 8 ], "name": "Keita Maki", "orcid": "0009-0003-2035-1940" }, { "affs": [ 9 ], "name": "Goki Suda" }, { "affs": [ 9 ], "name": "Takuya Sho", "orcid": "0000-0001-7943-3842" }, { "affs": [ 10 ], "name": "Yoshiya Yamamoto" }, { "affs": [ 11 ], "name": "Masaru Baba", "orcid": "0000-0002-4142-3267" }, { "affs": [ 12 ], "name": "Takashi Meguro" }, { "affs": [ 0 ], "name": "Hirotake Sakuraba", "orcid": "0000-0002-6075-1282" }, { "affs": [ 9 ], "name": "Naoya Sakamoto", "orcid": "0000-0003-0061-059X" }, { "affs": [ 8 ], "name": "Yoshiyuki Ueno", "orcid": "0000-0001-5623-4250" }, { "affs": [ 1 ], "name": "Hidekatsu Kuroda", "orcid": "0000-0002-1471-1087" } ], "bibtex": "https://research.draconitic.com/paper/cdh8e9abf2h5f.bib", "cited_by": 0, "doi": "10.3390/cancers18203366", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13702456/?tool=EBI", "id": "cdh8e9abf2h5f", "issns": [ "2072-6694" ], "landing_url": "https://www.mdpi.com/2072-6694/18/20/3366", "language": "eng", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2721|Hepatocellular Carcinoma Treatment and Prognosis" ] ], "openalex": "W7222944046", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13702456/pdf/?tool=EBI", "pmcid": "PMC13702456", "pmid": null, "published": "2026-10-01", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/cdh8e9abf2h5f.ris", "sources": [ { "first_seen": "2026-10-30T12:19:58Z", "native_id": "10.3390/cancers18203366", "source": "crossref", "url": "https://www.mdpi.com/2072-6694/18/20/3366" }, { "first_seen": "2026-10-30T12:21:47Z", "native_id": "PMC:PMC13702456", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13702456" } ], "subjects": [ { "field": "medicine", "origin": "issn:2072-6694", "subfield": "oncology" } ], "title": "Baseline Host Biomarkers and Six-Month Sustained Drug-Free Status After Atezolizumab–Bevacizumab for Hepatocellular Carcinoma: Exploratory Clinical Stratification Using PAN-DF Score", "title_text": "Baseline Host Biomarkers and Six-Month Sustained Drug-Free Status After Atezolizumab–Bevacizumab for Hepatocellular Carcinoma: Exploratory Clinical Stratification Using PAN-DF Score", "type": "peer-reviewed", "updated_at": "2026-10-30T12:21:47Z", "url": "https://research.draconitic.com/paper/cdh8e9abf2h5f", "venue": "Cancers", "versions": [] }