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乐伐替尼联合经动脉化疗栓塞术与索拉非尼联合经动脉化疗栓塞术治疗不可切除肝细胞癌的网状Meta分析

Lenvatinib in combination with transarterial chemoembolization vs. sorafenib in combination with transarterial chemoembolization for unresectable hepatocellular carcinoma: A network meta‑analysis.

作者信息

Li Yong, Liu Xingyu, Liu Junning, Yang Linfeng, Wei Song, Li Jijiang, Gan Huixin, Ma Ting, Yi Pengsheng

机构信息

Department of Hepato-Biliary-Pancrease II, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.

Department of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.

出版信息

Oncol Lett. 2024 Jun 3;28(2):347. doi: 10.3892/ol.2024.14480. eCollection 2024 Aug.

Abstract

The use of tyrosine kinase inhibitors combined with transarterial chemoembolization (TACE) is considered the standard therapy for patients with unresectable hepatocellular carcinoma (uHCC). However, information regarding the efficacy of lenvatinib or sorafenib in combination with TACE for patients with uHCC is limited. The present study involved a systematic search for randomized controlled trials on the PubMed, Embase, Web of Science and the Cochrane Library online databases to compare the use of TACE combined with either lenvatinib or sorafenib, and monotherapy using either lenvatinib or sorafenib for patients with uHCC. The network meta-analysis of the present study included eight randomized controlled trials involving 2,929 patients. The random-effects model was used, and hazard ratios and risk ratios with 95% CIs were calculated. Lenvatinib in combination with TACE provided the maximal overall survival (97.92%), progression-free survival (87.8%), objective response (96.68%) and disease control (96.27%) rates. The results of the present study indicated that, in the treatment of patients with uHCC, lenvatinib in combination with TACE showed a significantly improved efficacy when compared with sorafenib and TACE. Therefore, in the future, combination therapy of lenvatinib with TACE could be potentially prioritized over sorafenib with TACE for the treatment of patients with uHCC.

摘要

酪氨酸激酶抑制剂联合经动脉化疗栓塞术(TACE)被认为是不可切除肝细胞癌(uHCC)患者的标准治疗方法。然而,关于乐伐替尼或索拉非尼联合TACE治疗uHCC患者疗效的信息有限。本研究系统检索了PubMed、Embase、Web of Science和Cochrane图书馆在线数据库中的随机对照试验,以比较TACE联合乐伐替尼或索拉非尼,以及乐伐替尼或索拉非尼单药治疗uHCC患者的疗效。本研究的网络荟萃分析纳入了8项涉及2929例患者的随机对照试验。采用随机效应模型,计算了风险比和95%置信区间的风险比。乐伐替尼联合TACE的总生存率(97.92%)、无进展生存率(87.8%)、客观缓解率(96.68%)和疾病控制率(96.27%)最高。本研究结果表明,在治疗uHCC患者时,乐伐替尼联合TACE与索拉非尼联合TACE相比,疗效显著提高。因此,未来在治疗uHCC患者时,乐伐替尼联合TACE可能比索拉非尼联合TACE更具优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb2/11170262/d5cb9c95b7d6/ol-28-02-14480-g00.jpg

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