537 Background: Hepatitis-associated hepatocellular carcinoma (HCC) exhibits clinical benefits from immune checkpoint inhibitors (ICIs), whereas metabolic dysfunction-associated HCC demonstrates limited therapeutic efficacy from ICI treatment. Given the rising clinical prevalence of comorbid hepatitis B virus (HBV)-associated HCC and metabolic syndrome (Mts), there is an urgent need to investigate the impact of this comorbidity on immunotherapy efficacy and safety. Methods: In this multi-center retrospective study, we included 276 advanced HBV-related HCC patients from three medical centers who received anti-PD-L1 based therapy from January 2020 to October 2024. Mts was diagnosed based on the American Heart Association/National Heart, Lung, and Blood Institute criteria. Patients were divided into two groups: Mts group and non-Mts group. Propensity score matching (PSM) was performed to mitigate baseline confounding. Results: Before PSM, there were no significant differences in OS (median OS: 39.7 months vs. Not reached, p =0.75), PFS (median PFS: 12.2 months vs. 12.9 months, p =0.64), ORR (54.05% vs. 63.6%, p =0.28) or DCR (86.49% vs. 92.05%, p =0.34) between the Mts group and non- Mts groups. After PSM, still no significant difference in OS (median OS: 39.7 months vs. Not reached, p =0.77), PFS (median PFS: 12.2 months vs. 13.8 months, p =0.98), or ORR (56.67% vs. 67.19%, p =0.30) were observed between these two groups. DCR was significantly higher in non-Mts group compared to Mts group (83.33% vs. 95.53%, p =0.027). No statistically significant difference emerged in any grade adverse events (AEs) (97.30% vs. 97.91%, p>0.05) and grade 3 or 4 AE rates between Mts group and non-Mts group (32.43% vs. 44.35%, p = 0.24). Conclusions: From our results, concomitant metabolic syndrome did not significantly affect the therapeutic efficacy and increase the incidence of treatment-related AEs of anti-PD-L1 treatment in HBV-associated HCC.
Zhou et al. (Sat,) studied this question.