Impact of Emotional Disorders on Response to Immune Checkpoint Inhibitor Therapy in Liver Cancer

Summary

Hepatocellular carcinoma (HCC) carries a poor prognosis, with limited efficacy from current therapies including immune checkpoint inhibitors (ICIs). Concurrently, emotional distress (ED) is highly prevalent in cancer patients and is implicated in tumor progression via neuroendocrine-immune axis dysregulation (e.g., HPA axis activation, immunosuppressive TME). Emerging evidence, particularly from lung cancer, suggests ED may adversely impact ICI efficacy. However, its specific role and clinical significance in HCC, especially regarding ICI response, remain poorly understood. To address this gap, we propose a large-scale, prospective, multicenter, multi-cohort study to systematically evaluate the impact of ED on treatment outcomes in HCC patients receiving immunotherapy.

Eligibility

Inclusion Criteria:

* Age between 18 and 75 years, inclusive, regardless of gender.
* Presence of at least one radiologically measurable lesion according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 (defined as a lesion with a longest diameter of ≥10 mm on CT scan).
* Newly diagnosed, treatment-naïve patients with hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC).
* Child-Pugh liver function score ≤ 7.
* Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
* Absence of severe organic diseases affecting the heart, lungs, brain, or other major organs.

Exclusion Criteria:

* History of other malignancies.
* Recurrent HCC.
* Prior systemic therapy for HCC.
* Hepatic decompensation.
* History of severe psychiatric disorders.
* Current use of antidepressant or anxiolytic medication.
* Inability to comprehend or complete the assessment questionnaires.

Conditions4

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