FIT scoring may help predict survival in patients with unresectable hepatocellular carcinoma (uHCC) receiving combined treatment with transarterial chemoembolization (TACE), lenvatinib, and programmed death-1 (PD-1) inhibitors, according to a multicentre study.
The model combines three clinical measures to stratify patients by their risk of poor outcomes and could support prognostic assessment during treatment.
Researchers analysed 265 patients with uHCC who received the three-treatment combination across three medical centres.
Researchers investigated clinical factors associated with overall survival (OS). Multivariable analysis identified three independent predictors: fibrin degradation products (FDP), serum iron levels, and tumour burden score (TBS). These variables were combined to establish the FIT model.
The researchers set cut-off values of 4.7 mg/dL for FDP, 60.0 mg/dL for serum iron, and 8.0 for TBS. Patients were classified into low-, intermediate-, and high-risk groups according to their FIT scores.
The FIT model achieved an area under the curve (AUC) of 0.809 in the training cohort and 0.798 in the validation cohort. Its predictive performance was also higher than that of individual variables and several existing measures assessed in the study.
Survival analyses showed significant differences in OS and progression-free survival (PFS) between the three FIT risk groups in both cohorts.
Across all patients, the objective response rate was 52.5%, and the disease control rate was 77.7%. Treatment-related adverse events were common, with abnormal liver function the most frequently reported event in both cohorts. No treatment-related deaths occurred.
Researchers concluded that the FIT model could provide a convenient approach to prognostic stratification for patients with uHCC receiving triple therapy.
However, the study’s retrospective design, relatively short follow-up, and limited sample size may affect the generalisability of the findings. Most participants had hepatitis B virus infection, and the model did not demonstrate statistically significant prognostic stratification in the validation cohort’s stage B subgroup.
Researchers called for larger prospective studies across different centres to confirm the model’s clinical utility and assess its applicability to broader patient populations.
Reference:
Liao M et al. A novel clinical FIT model predicts prognosis of unresectable hepatocellular carcinoma treated with TACE combined with lenvatinib and PD-1 inhibitors therapy. Front Immunol. 2026. DOI; 10.3389/fimmu.2026.1906593.
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