{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:06:56Z","timestamp":1789175216509,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>For unresectable hepatocellular carcinoma (HCC), atezolizumab plus bevacizumab (Atez\/Bev) and durvalumab plus tremelimumab (Dur\/Tre) are widely used first\u2010line immunotherapies; however, biomarkers to guide regimen selection before treatment initiation remain undefined. We investigated whether baseline des\u2010\u03b3\u2010carboxy prothrombin (DCP) modifies objective response rate (ORR) according to treatment regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed 1464 patients with unresectable HCC treated with first\u2010line systemic therapy between 2020 and 2025 across multiple centers. Patients were divided into training and validation cohorts. Restricted cubic spline\u2010based interaction models were used to evaluate the association between baseline DCP and ORR according to treatment regimen. The predicted absolute difference in ORR (\u0394ORR) between regimens was examined across continuous DCP values, with a prespecified 10% threshold considered clinically meaningful. Robustness was assessed using leave\u2010one\u2010center\u2010out and repeated random\u2010split sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall ORR did not differ significantly between Atez\/Bev and Dur\/Tre. However, a significant interaction between baseline DCP and treatment regimen was observed in both cohorts. Atez\/Bev showed a relatively stable ORR across DCP concentrations, whereas Dur\/Tre showed a DCP\u2010dependent increase in ORR. At low DCP levels, Atez\/Bev was favoured; with increasing DCP levels, the relative benefit shifted toward Dur\/Tre. Sensitivity analyses confirmed a consistent DCP\u2010dependent transition pattern, although the DCP level at which \u0394ORR exceeded 10% varied across analyses, supporting a transition zone rather than a fixed cutoff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline DCP may modify the relative treatment benefit between Atez\/Bev and Dur\/Tre in unresectable HCC. Rather than defining a rigid cutoff, DCP appears to delineate a continuum in which higher levels increasingly favour Dur\/Tre, providing a practical framework for individualized immunotherapy selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70803","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:22:16Z","timestamp":1784604136000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline\n                    <scp>DCP<\/scp>\n                    May Modify Response to Atezolizumab\u2010Bevacizumab Versus Durvalumab\u2010Tremelimumab in Unresectable\n                    <scp>HCC<\/scp>"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9811-2665","authenticated-orcid":false,"given":"Kazunari","family":"Tanaka","sequence":"first","affiliation":[{"name":"Center for Gastroenterology, Teine Keijinkai Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4152-9364","authenticated-orcid":false,"given":"Kunihiko","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Center for Gastroenterology, Teine Keijinkai Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1989-0480","authenticated-orcid":false,"given":"Atsushi","family":"Hiraoka","sequence":"additional","affiliation":[{"name":"Gastroenterology Center, Ehime Prefectural Central Hospital  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0976-6761","authenticated-orcid":false,"given":"Toshifumi","family":"Tada","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"},{"name":"Department of Internal Medicine Japanese Red Cross Himeji Hospital  Himeji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5634-5313","authenticated-orcid":false,"given":"Masashi","family":"Hirooka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3996-7502","authenticated-orcid":false,"given":"Kazuya","family":"Kariyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Okayama City Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8801-2505","authenticated-orcid":false,"given":"Joji","family":"Tani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Neurology Kagawa University  Kagawa 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