A baseline-lymphocyte-subset nomogram for predicting severe immune-related adverse events in hepatocellular carcinoma patients receiving TACE plus immunotherapy

Abstract

Aim: This study aimed to construct and validate a nomogram model to predict the occurrence of severe immune-related adverse events (sirAEs) (≥ 3 grade) in hepatocellular carcinoma (HCC) patients receiving transcatheter arterial chemoembolization (TACE) plus immunotherapy.

Methods: Data regarding lymphocyte subpopulations and clinical characteristics of 130 HCC patients treated from January 2020 to June 2024 were retrospectively analyzed, including 46 patients with sirAEs and 84 patients without sirAEs. Univariate logistic regression analysis was used to summarize the factors that might affect the occurrence of sirAEs in patients, and then these factors were included in the multivariate logistic regression analysis. These influencing factors were then included in the construction of the nomogram prediction model. Receiver operating characteristic (ROC) and calibration curves were used to verify the nomogram prediction model.

Results: Multivariate logistic regression analysis indicated that liver cirrhosis, lower value of Neutrophil-to-Lymphocyte Ratio and Regulatory T cell, and higher value of lymphocytes and creatinine were significantly associated with sirAEs (P < 0.05). Based on these factors, a nomogram prediction model for predicting sirAEs after TACE plus immunotherapy in HCC patients was constructed. The area under the ROC curve (AUC) for the prediction model was 0.885 (95% confidence interval: 0.820-0.951), with a cut-off value of 137.786. The model demonstrated a sensitivity of 0.812 and a specificity of 0.889.

Conclusion: The nomogram model developed in this study shows promising predictive performance for sirAEs in HCC patients receiving TACE plus immunotherapy; however, further validation in larger, multi-center prospective cohorts is needed to confirm its generalizability and clinical utility.

Keywords

Hepatocellular carcinoma / transcatheter arterial chemoembolization immunotherapy / immune-related adverse events / logistic regression analysis / prediction model

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