This study aimed to evaluate the therapeutic efficacy and prognostic significance of C-reactive protein (CRP) in patients with advanced hepatocellular carcinoma (HCC) receiving durvalumab and tremelimumab (Dur/Tre).

Methods

A total of 167 patients treated with Dur/Tre between March 2023 and March 2024 in Japanese hospitals were included in this retrospective multicentre study. Patients were divided into two groups based on pre-treatment serum CRP levels: the low-CRP group (< 1 mg/dL, n = 106) and the high-CRP group (≥ 1 mg/dL, n = 61).

Results

The median age of the cohort was 74.0 years (interquartile range, 67.5–79.5), and 139 patients (83.2%) were male. The median progression-free survival (PFS) was 3.6 months (95% CI: 2.6–5.4) in the low-CRP group and 2.4 months (95% CI: 1.9–4.1) in the high-CRP group, with statistical significance (p = 0.02). The median overall survival (OS) was not reached in the low-CRP group, with a 1-year survival rate of 64.7% (95% CI: 49.0–76.7), while it was 7.9 months (95% CI: 5.8–11.8) in the high-CRP group. The low-CRP group demonstrated significantly better survival outcomes compared to the high-CRP group (p < 0.001). Multivariate analysis identified serum CRP level as an independent predictive factor for both PFS and OS (p = 0.04 and < 0.001, respectively). No significant differences in immune-related adverse events were observed between the two groups.

Conclusions

Serum CRP may serve as a prognostic biomarker in HCC patients receiving Dur/Tre, with a potential association with treatment efficacy.

Conflicts of Interest

Takeshi Hatanaka received lecture fees from Eisai. Atsushi Hiraoka received lecture fees from Eli Lilly, AstraZeneca and Chugai. Toshifumi Tada received lecture fees from AbbVie, Eisai and Chugai. Satoru Kakizaki received lecture frees from AbbVie. Hidenori Toyoda received lecture fees from Eisai, Chugai, Takeda, Terumo, AbbVie, Gilead, Fujifilm WAKO, Abott, Kowa, AstraZeneca and Bayer. Hidekatsu Kuroda received lecture fee from Eisai. Kazuhiro Nouso received lecture fees from AbbVie, Aska Pharmaceutical, AstraZeneca, Bayer, Century Medical, Chugai, Covidien, Eisai, Gilead, Kowa, Lilly and Otsuka; and received research funding from CureApp, Denka, Fuji film and Medtronic. Masatoshi Kudo received honoraria from Bayer, Chugai, Eisai, Eli Lilly, MSD and Takeda; and received research funding from AbbVie, EA Pharma, Eisai, GE Healthcare, Gilead Sciences, Otsuka, Sumitomo Dainippon Pharma, Taiho and Takeda. The other authors declare no conflicts of interest associated with this study.

Open Research

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Supporting Information

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Citing Literature

Volume45, Issue7

July 2025

e70192

Filename	Description
liv70192-sup-0001-FigureS1.tifTIFF image, 561.4 KB	Figure S1. Patient selection process. BCLC, Barcelona Clinic Liver Cancer; CRP, C-reactive protein; Dur/Tre, durvalumab and tremelimumab; HCC, hepatocellular carcinoma; PS, performance status.
liv70192-sup-0002-FigureS2.tifTIFF image, 935.1 KB	Figure S2. (a) Progression-free survival was adjusted for age, gender, treatment line, BCLC stage, mALBI grade, serum AFP level and serum DCP level using Cox proportional hazards regression models. One patient in the low-CRP group was excluded due to missing DCP data. (b) Overall survival was adjusted for age, gender, treatment line and BCLC stage.

Clinical Impact of Serum CRP Levels on Advanced HCC Treated With Durvalumab and Tremelimumab: A Multicentre Study

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Conflicts of Interest

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Clinical Impact of Serum CRP Levels on Advanced HCC Treated With Durvalumab and Tremelimumab: A Multicentre Study

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Exploring the Prognostic Role of CRP in Advanced Hepatocellular Carcinoma Treated With Durvalumab and Tremelimumab

Serum CRP in Durvalumab-Tremelimumab Treated HCC: Expanding the Inflammatory Narrative

ABSTRACT

Aim

Methods

Results

Conclusions

Conflicts of Interest

Open Research

Data Availability Statement

Supporting Information

References

Citing Literature

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