Prognostic Association of the Two-Cycle On-Treatment CRAFITY Score in Advanced HCC: A Single-Center Retrospective Cohort Study.

Authors

Xiaochun Chen, Xinkun Guo, Guobin Chen, Susu Zheng, Yanfang Wu, Jingfang Wu, Hong Chen, Zhenzhen Zhang, Boheng Zhang

Published in

Current oncology (Toronto, Ont.). Volume 33. Issue 10. Oct 02, 2026. Epub Oct 02, 2026.

Abstract

The baseline CRAFITY score, derived from AFP and C-reactive protein, is a validated prognostic biomarker for hepatocellular carcinoma (HCC) patients receiving immunotherapy. However, whether its prognostic value can be improved by on-treatment reassessment remains unclear. We evaluated the two-cycle on-treatment CRAFITY score in 108 advanced-HCC patients who received immune-based combination therapy as first- or second-line treatment. The score was calculated at baseline and after two cycles. Kaplan-Meier, Cox regression, time-dependent ROC, landmark, and sensitivity analyses were performed. The two-cycle score significantly stratified overall survival (median OS from landmark: 34.6, 12.9, and 6.7 months for scores 0, 1, and 2; p < 0.0001) and remained independently associated with OS after adjustment for vascular invasion, treatment line, and concomitant transarterial chemoembolization (TACE) (HR 2.36, 95% CI 1.70-3.29, p < 0.001). The baseline score showed only borderline associations (OS p = 0.07; PFS p = 0.09). The two-cycle score had an apparent AUC of 0.709 (95% CI 0.586-0.832) at 6 months and 0.745 (95% CI 0.658-0.832) at 12 months. The corresponding values for the baseline score were 0.645 and 0.638. Adding the two-cycle score to a clinical reference model increased the 12-month AUC from 0.699 to 0.811 (ΔAUC = 0.112). Bootstrap internal validation yielded an optimism-corrected C-index of 0.698 (95% CI 0.650-0.776). In conclusion, the two-cycle CRAFITY score provides complementary posttreatment prognostic information for early risk stratification, but prospective external validation is required before clinical application.

PMID:
42930165
Bibliographic data and abstract were imported from PubMed on 26 Oct 2026.

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