PT - JOURNAL ARTICLE AU - Han, Jiaxin AU - Kuai, Wentao AU - Yang, Liu AU - Tao, Xuemei AU - Wang, Yuekui AU - Zeng, Minghui AU - Li, Yuqin AU - Mi, Yuqiang AU - Zhang, Ningning AU - Lu, Wei AU - Xu, Liang TI - Impact of metabolic dysfunction-associated steatotic liver disease on the efficacy of immunotherapy in patients with chronic hepatitis B-related hepatocellular carcinoma AID - 10.20892/j.issn.2095-3941.2024.0048 DP - 2024 Sep 15 TA - Cancer Biology & Medicine PG - 813--825 VI - 21 IP - 9 4099 - http://www.cancerbiomed.org/content/21/9/813.short 4100 - http://www.cancerbiomed.org/content/21/9/813.full SO - Cancer Biology & Medicine2024 Sep 15; 21 AB - Objective: To investigate the impact of metabolic dysfunction-associated steatotic liver disease (MASLD) on the efficacy of immune checkpoint inhibitor (ICI)-based therapy in patients with chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC).Methods: A total of 155 patients with CHB-related HCC who received ICI–based therapy (in the Department of Hepatology, Tianjin Second People’s Hospital and Department of Hepatobiliary Oncology, Tianjin Medical University Cancer Institute & Hospital) between April 2021 and December 2023 were evaluated. Patients were divided into two groups: MASLD concurrent with CHB [MASLD-CHB] (n = 38), and CHB (n = 117).Results: The median progression-free survival (PFS, 6.9 months vs. 9.3 months; P = 0.001), progressive disease (57.89% vs. 37.61%; P = 0.028), and disease control rate (42.11% vs. 62.39%; P = 0. 028) in the MASLD-CHB group were significantly worse than the CHB group. The median overall survival was not attained. The percentage of CD4+PD1+ (17. 56% vs. 8.89%; P < 0.001) and CD8+PD1+ T cells (10.50% vs. 7.42%; P = 0.005) in patient samples from the MASLD-CHB group were significantly higher than the CHB group. Concurrent MASLD [hazard ratio (HR) = 1.921; 95% CI, 1.138–3.245; P = 0.015] and alpha-fetoprotein levels after 3 months of treatment (HR = 2.412; 95% CI, 1.360–4.279; P = 0.003) were independent risk factors for PFS in all patients.Conclusions: ICI-based therapy in patients with CHB-related HCC and concurrent MASLD resulted in poorer efficacy and shorter PFS compared to patients with CHB-related HCC alone.The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.