Prognostic factors of nivolumab in advanced hepatocellular carcinoma: a systematic review and meta-analysis.

Background Hepatocellular carcinoma (HCC) is the sixth most common cancer globally, and a major unresolved medical issue. According to guideline recommendations of European Association for the Study of the Liver in 2018 and American Society for Clinical Oncology (ASCO) Guideline, nivolumab are reasonable options for appropriate advanced stage HCC. Methods We searched the PubMed, Embase and CNKI (China National Knowledge Infrastructure) databases for all articles within a range of published years from 2010 to 2020 of nivolumab in advanced hepatocellular carcinoma, and carried out this meta-analysis on all published studies to estimate prognostic factors of nivolumab in advanced hepatocellular carcinoma. Results Finally, 6 studies with 627 advanced hepatocellular carcinoma patients treated with nivolumab met the inclusion criteria for this study. Our results indicated that α -fetoprotein (AFP), eastern Cooperative Oncology Group (ECOG) performance status, Child-Pugh class, portal vein invasion, protein induced by vitamin K absence-II (PIVKA-II), and albumin-bilirubin (ALBI) score were prognostic factor of nivolumab in advanced hepatocellular carcinoma, but hepatitis C virus (HBV) infection, barcelona Clinic Liver Cancer (BCLC) stage, and extrahepatic metastasis were not significant prognostic factors. Conclusions Our meta-analysis indicated the potential prognostic factor of nivolumab in advanced hepatocellular carcinoma. However, ongoing clinical and translational research may provide us a better understanding of the prognostic factor and mechanisms.