2152P - Prognostic importance of GRIM score on sorafenib side effects, hospitalization and survival in hepatocellular cancer patients

Background

The Gustave Roussy Immune Score (GRIm-Score) was first used in 2017 as a prognostic index. Since the immune pathways in the pathogenesis of HCC has been demonstrated, it was aimed to examine the relationship between GRIm-score and patient survival, treatment side effects and the frequency of hospitalization in HCC patients.

Methods

In between 2010-2021, 108 patients with metastatic or unresectable HCC in our center were screened. Patients receiving sorafenib therapy and ecog 0-1 were included. Clinicopathological data, GRIm scores prior to the sorafenib treatment, previous treatment modalities of patients, hematological side effects of sorafenib, and hospitalizations to the oncology inpatient ward, excluding hospitalizations for planned procedure or chemotherapy, were recorded retrospectively. For the GRIM-Score, patients with NLR > 4.8, LDH > upper limit of normal, or albumin < 3.5 g/dL were given 1 point. Patients were divided in two groups according to the GRIM-Score as low and high.

Results

Sixty four patients were included in the study. Median age was 65 and 95.3% of the patients were male. 79.7% of them had chronic hepatitis. Most of the patients (68%) performed previous local ablative therapy. Low GRIM score (0-1) was demonstrated 60.9% of patients, whereas 39.1% of them had high score(2-3). Hematological side effects and/or AST elevation were observed in 32% of the patients. Hematological side effects were seen in 23% of all patients. During the follow-up period, 75.2% of the patients were hospitalized at least once. 72% of hospitalizations were for supportive treatment. The median number of hospitalizations was 1. The median OS was 5 months. The median survival in the low and high GRIm-score group was 8.8 and 2.7 months respectively (p<0.0001). Hospitalization requirement was found to be significantly higher in the high-GRIm score group compared to low GRIm-score group (p: 0.017). There was no significant difference between the presence of side effects and the GRIm-score group (p: 0.664).

Conclusions

The GRIm-score at the beginning of sorafenib therapy can be used as a significant marker both to determine survival and to predict the need for supportive care in metastatic/unresectable HCC patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.