Journal Article

DKFZ-2026-02493

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png ALBI-6-A Novel Prognostic Score Combining ALBI and Interleukin-6 in Patients With HCC Treated With Atezolizumab and Bevacizumab.

Bark, P. ; Wiesmann, L. ; Gairing, S. J. ; Shmanko, K. ; Müller, L. ; Moos, M. ; Stöhr, F. ; Graafen, D. ; Emrich, T. ; Hahn, F. ; Dos Santos, D. P. ; Scheiner, B. ; Berger, V. B. ; Pinter, M. ; Zarka, V. ; Reiter, F. P. ; Geier, A. ; Khaled, N. B. ; Philipp, A. ; Springfeld, C. ; Tomczak, A. ; Dill, M.DKFZ* ; Scholz, C. ; Mittler, J. ; Lang, H. ; Straub, B. K. ; Kloeckner, R. ; Bäuerle, T. ; Lange, C. M. ; Weinmann, A. ; Galle, P. R. ; Foerster, F.

2026
Blackwell Science Oxford

Abstract: Despite widespread use of combination immunotherapy in advanced liver cancer, reliable biomarkers for baseline risk stratification remain lacking. The inflammatory cytokine interleukin-6 has established prognostic relevance in this cancer. We investigated the prognostic value of interleukin-6 and developed a combined score (ALBI-6) integrating interleukin-6 with albumin-bilirubin grade, a marker of liver function.In this multicentre retrospective cohort study, 216 patients with advanced hepatocellular carcinoma treated with first-line atezolizumab plus bevacizumab were analysed. Interleukin-6 was measured at baseline, first response, best response, and progression. The cohort was randomly divided into a training set (n = 98) and a validation set (n = 90). ALBI-6 was derived using Cox regression and evaluated against several established prognostic scores.Elevated baseline interleukin-6 was consistently associated with worse overall survival and remained independently prognostic after adjustment for tumour and clinical factors (extrahepatic spread, vascular invasion, alpha-fetoprotein, performance status, liver function class). In the validation cohort, ALBI-6 achieved a concordance index of 0.716 and separated patients into three risk groups with significantly different survival (log-rank p = 0.002); ALBI-6 was significantly more discriminative than one comparator score (modified albumin-bilirubin grade, p = 0.040), with numerically higher performance than the remaining comparators. In a separate analysis of the full cohort, ALBI-6 significantly outperformed the CRAFITY score at all assessed time points. Bootstrap validation confirmed model stability.ALBI-6 integrates systemic inflammation and liver function into a simple composite index enabling meaningful risk stratification in patients with advanced hepatocellular carcinoma treated with immunotherapy. Prospective external validation is warranted.

Keyword(s): IL‐6 ; cirrhosis ; hepatocellular carcinoma ; immune checkpoint inhibitors ; immunotherapy ; prognostic score ; systemic therapy

Note: epub

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Contributing Institute(s):

1. NWG Experimentelle Hepatologie, Entzündung und Krebs (D500)

Research Program(s):

1. 314 - Immunologie und Krebs (POF4-314) (POF4-314)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Wiley ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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