odmj
OncoDaily Medical Journal
ODMJ
3067-6444
OncoDaily Medical Journal
US
8138
10.69690/ODMJ-001-1026-8138
Original Research
Association of Alpha-Fetoprotein and Clinical Outcomes in Patients with Unresectable Hepatocellular Carcinoma Treated with First-Line Camrelizumab Plus Rivoceranib vs Sorafenib: Post Hoc Exploratory Analysis of the CARES-310 Trial
https://orcid.org/0000-0002-8448-844X
Kim
Richard
Moffitt Cancer Center, Tampa, FL, USA.
richard.kim@moffitt.org
https://orcid.org/0009-0001-5146-8821
Shi
Wei
Jiangsu Hengrui Pharmaceuticals, Shanghai, China.
https://orcid.org/0000-0003-1150-6405
Wu
Xiuzhi
Jiangsu Hengrui Pharmaceuticals, Shanghai, China.
https://orcid.org/0009-0007-8444-2728
Meng
Xianzhang
Elevar Therapeutics, Fort Lee, NJ, USA.
https://orcid.org/0009-0007-6578-7210
Ryan
Kristin
Elevar Therapeutics, Fort Lee, NJ, USA.
https://orcid.org/0000-0001-8998-5480
Chan
Stephen
State Key Laboratory of Translational Oncology, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, China.
https://orcid.org/0000-0003-0560-5538
Vogel
Arndt
Princess Margaret Cancer Centre, Toronto, ON, Canada.
09
10
2026
Received: 21052026
Accepted: 18082026
ODMJ-001-1026-8138
Copyright (c) 2026 OncoDaily Medical Journal
2026
OncoDaily Medical Journal
alpha-fetoprotein
camrelizumab
CARES-310
GI Cancer in 2026
Hepatocellular carcinoma
rivoceranib
sorafenib
Special Series
production-ready-file-url
[
Abboud Y, Ismail M, Khan H, et al. Hepatocellular carcinoma incidence and mortality in the USA by sex, age, and race: a nationwide analysis of two decades. J Clin Transl Hepatol. 2024;12(2):172-81.
]
[
Singal AG, Llovet JM, Yarchoan M, et al. AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology. 2023;78(6):1922-65.
]
[
Ahn JC, Lee YT, Agopian VG, et al. Hepatocellular carcinoma surveillance: current practice and future directions. Hepatoma Res. 2022;8:10.
]
[
Yeo YH, Lee YT, Tseng HR, et al. Alpha-fetoprotein: past, present, and future. Hepatol Commun. 2024;8(5).
]
[
Qin S, Chan SL, Gu S, et al. Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): a randomised, open-label, international phase 3 study. Lancet. 2023;402(10408):1133-46.
]
[
Qin S, Gu S, Chan SL, et al. Camrelizumab plus rivoceranib versus sorafenib as first-line therapy for unresectable hepatocellular carcinoma (CARES-310): final analysis of a randomised, open-label, international, phase 3 study. Lancet Oncol. 2025;26(12):1598-611.
]
[
Cancer of the Liver Italian Program (CLIP) Investigators. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients: the Cancer of the Liver Italian Program (CLIP) investigators. Hepatology. 1998;28(3):751-5.
]
[
Tangkijvanich P, Anukulkarnkusol N, Suwangool P, et al. Clinical characteristics and prognosis of hepatocellular carcinoma: analysis based on serum alpha-fetoprotein levels. J Clin Gastroenterol. 2000;31(4):302-8.
]
[
Zhang XF, Meng B, Qi X, et al. Prognostic factors after liver resection for hepatocellular carcinoma with hepatitis B virus-related cirrhosis: surgeon’s role in survival. Eur J Surg Oncol. 2009;35(6):622-8.
]
[
Mailey B, Artinyan A, Khalili J, et al. Evaluation of absolute serum alpha-fetoprotein levels in liver transplant for hepatocellular cancer. Arch Surg. 2011;146(1):26-33.
]
[
Zhou J, Sun HC, Wang Z, et al. Guidelines for diagnosis and treatment of primary liver cancer in China (2017 Edition). Liver Cancer. 2018;7(3):235-60.
]
[
Brookmeyer R, Crowley J. A confidence interval for the median survival time. Biometrics. 1982;38(1):29-41.
]
[
Hoshida Y, Nijman SM, Kobayashi M, et al. Integrative transcriptome analysis reveals common molecular subclasses of human hepatocellular carcinoma. Cancer Res. 2009;69(18):7385-92.
]
[
European Association for the Study of the Liver. EASL clinical practice guidelines on the management of hepatocellular carcinoma. J Hepatol. 2025;82(2):315-74.
]
[
Zhu AX, Park JO, Ryoo BY, et al. Ramucirumab versus placebo as second-line treatment in patients with advanced hepatocellular carcinoma following first-line therapy with sorafenib (REACH): a randomised, double-blind, multicentre, phase 3 trial. Lancet Oncol. 2015;16(7):859-70.
]
[
Zhu AX, Kang YK, Yen CJ, et al. Ramucirumab after sorafenib in patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations (REACH-2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019;20(2):282-96.
]
[
Hsu WF, Wang HW, Chen CK, et al. Alpha-fetoprotein response predicts treatment outcomes in patients with unresectable hepatocellular carcinoma receiving immune checkpoint inhibitors with or without tyrosine kinase inhibitors or locoregional therapies. Am J Cancer Res. 2021;11(12):6173-87.
]
[
Zhu AX, Dayyani F, Yen CJ, et al. Alpha-fetoprotein as a potential surrogate biomarker for atezolizumab + bevacizumab treatment of hepatocellular carcinoma. Clin Cancer Res. 2022;28(16):3537-45.
]
[
Kelley RK, Meyer T, Rimassa L, et al. Serum alpha-fetoprotein levels and clinical outcomes in the phase III CELESTIAL study of cabozantinib versus placebo in patients with advanced hepatocellular carcinoma. Clin Cancer Res. 2020;26(18):4795-804.
]
[
Chau I, Park JO, Ryoo BY, et al. Alpha-fetoprotein kinetics in patients with hepatocellular carcinoma receiving ramucirumab or placebo: an analysis of the phase 3 REACH study. Br J Cancer. 2018;119(1):19-26.
]