Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of General Surgery, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2023 Jun 9;102(23):e33852. doi: 10.1097/MD.0000000000033852.
Assess the effectiveness and safety of treatment options atezolizumab plus bevacizumab (Atez/Bev) or lenvatinib in clinical practice for patients with advanced hepatocellular carcinoma (HCC) patients.
To compare the effectiveness of Atez/Bev and lenvatinib in treating advanced HCC, we systematically searched the PubMed, EMBASE, and Web of Science databases. We utilized Review Manager 5.3 to extract and analyze the data.
The present systematic review included 8 nonrandomized studies comprising a total of 6628 cases. There was no significant difference in 0.5-, 1-, 1.5-year OS rates and 0.5-, 1-year PFS rates between the 2 groups. However, patients with HCC caused by viral hepatitis would benefit more from the Atez/Bev therapy (hazard ratio = 0.75, 95% confidence interval: 0.63-0.89) but patients with a Child-Pugh class B liver function would benefit more from lenvatinib (hazard ratio = 1.70, 95% confidence interval: 1.07-2.70). At the same time, there are no major differences in safety between the 2 treatment options.
Our study did not find any significant difference in effectiveness and safety between Atez/Bev and lenvatinib. However, Additional verification is required to determine whether these 2 therapeutic approaches have varying effects on distinct populations.
评估阿替利珠单抗联合贝伐珠单抗（Atez/Bev）或仑伐替尼在晚期肝细胞癌（HCC）患者临床实践中的治疗选择的有效性和安全性。
为了比较 Atez/Bev 和仑伐替尼治疗晚期 HCC 的效果，我们系统地检索了 PubMed、EMBASE 和 Web of Science 数据库。我们使用 Review Manager 5.3 提取和分析数据。
本系统评价包括 8 项非随机研究，共纳入 6628 例患者。两组患者的 0.5 年、1 年、1.5 年 OS 率和 0.5 年、1 年 PFS 率无显著差异。然而，病毒性肝炎引起的 HCC 患者从 Atez/Bev 治疗中获益更多（风险比=0.75，95%置信区间：0.63-0.89），而肝功能 Child-Pugh 分级 B 的患者从仑伐替尼治疗中获益更多（风险比=1.70，95%置信区间：1.07-2.70）。同时，两种治疗方案的安全性差异不大。
我们的研究没有发现 Atez/Bev 和仑伐替尼在有效性和安全性方面有任何显著差异。然而，需要进一步验证这两种治疗方法是否对不同人群有不同的影响。
