乐伐替尼与索拉非尼对晚期肝细胞癌患者生存影响的比较：一项系统评价和荟萃分析
Comparison of the effects of lenvatinib and sorafenib on survival in patients with advanced hepatocellular carcinoma: A systematic review and meta-analysis.
作者信息
Hu Lingbo, Zheng Yu, Lin Jiangyin, Shi Xingpeng, Wang Aidong
机构信息
Department of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Zhejiang, China; Department of Hepatopancreatobiliary Surgery, Enze Hospital, Taizhou Enze Medical Center (Group), Zhejiang, China.
Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu, China.
出版信息
Clin Res Hepatol Gastroenterol. 2023 Jan;47(1):102061. doi: 10.1016/j.clinre.2022.102061. Epub 2022 Dec 5.
BACKGROUND AND AIM
The first-line systemic therapy for advanced hepatocellular carcinoma (HCC) involves the use of sorafenib and lenvatinib. The present meta-analysis attempted to compare the therapeutic safety and effectiveness of the two drugs in advanced HCC.
METHODS
The library databases of Cochrane, Embase, PubMed, and Web of Science were systematically searched to identify eligible studies comparing the long-term outcomes of sorafenib and lenvatinib use in advanced HCC patients. Overall survival (OS) was considered the primary endpoint, whereas the progression-free survival (PFS), severe adverse events (AEs), objective response rate (ORR), and disease control rate (DCR) were considered the secondary endpoints.
RESULTS
The present systematic review included 8 nonrandomized studies and 1 randomized controlled trial, comprising a total of 1, 914 cases. OS in patients receiving lenvatinib was better than that in patients receiving sorafenib [hazard ratio (HR): 1.23; 95% confidence interval (CI): 1.04-1.45]. Additionally, patients who received lenvatinib exhibited better PFS, ORR, and DCR (HR: 0.89, 95% CI: 0.79-0.99), [odds ratio (OR: 7.50, 95% CI: 4.43-12.69)], (OR: 7.50, 95% CI: 4.43-12.69), but higher incidences of AEs than those receiving sorafenib (OR: 1.28, 95% CI: 1.08-1.53).
CONCLUSION
Lenvatinib is superior to sorafenib in treating unresectable HCC patients.
背景与目的
晚期肝细胞癌（HCC）的一线全身治疗包括使用索拉非尼和仑伐替尼。本荟萃分析旨在比较这两种药物在晚期HCC治疗中的安全性和有效性。
方法
系统检索Cochrane、Embase、PubMed和Web of Science的数据库，以确定比较索拉非尼和仑伐替尼用于晚期HCC患者长期疗效的合格研究。总生存期（OS）被视为主要终点，而无进展生存期（PFS）、严重不良事件（AE）、客观缓解率（ORR）和疾病控制率（DCR）被视为次要终点。
结果
本系统评价纳入了8项非随机研究和1项随机对照试验，共1914例患者。接受仑伐替尼治疗的患者的OS优于接受索拉非尼治疗的患者[风险比（HR）：1.23；95%置信区间（CI）：1.04 - 1.45]。此外，接受仑伐替尼治疗的患者的PFS、ORR和DCR更佳（HR：0.89，95%CI：0.79 - 0.99），[比值比（OR）：7.50，95%CI：4.43 - 12.69]，（OR：7.50，95%CI：4.43 - 12.69），但AE发生率高于接受索拉非尼治疗的患者（OR：1.28，95%CI：1.08 - 1.53）。
结论
在治疗不可切除的HCC患者方面，仑伐替尼优于索拉非尼。
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