Yu Xinlin, Cui Ran, Jiang Yan, Guo Ping
Department of Oncology, Affiliated Hospital Chengdu University Chengdu 610000, Sichuan, China.
Department of Emergency Medicine, The First People's Hospital of Neijiang Neijiang 641000, Sichuan, China.
Int J Clin Exp Pathol. 2024 Dec 15;17(12):444-457. doi: 10.62347/MBQJ8679. eCollection 2024.
Although the combination of atezolizumab and bevacizumab (A+B) shows promise for advanced hepatocellular carcinoma (HCC), its response rate is still inadequate. Previous studies indicate that the integration of FOLFOX-based hepatic arterial infusion chemotherapy (HAIC) with transarterial chemoembolization (TACE) is advantageous for the management of HCC. This meta-analysis aims to assess the safety and efficacy of the A+B+TACE or HAIC therapy protocol in patients with advanced HCC.
We collected pertinent studies from databases such as PubMed, Cochrane Library, Web of Science, and Embase, all published prior to August 1, 2024. We used Stata MP 14.0 software for data analysis, incorporating data extraction and quality assessment procedures.
Data synthesis employed a fixed-effects model in certain contexts and a random-effects model where significant variability was present. A total of 405 patients were involved over ten trials. The overall objective response rate (ORR) was 57.2% (95% CI, 46.9-67.6%), and the disease control rate (DCR) was 85.9% (95% CI, 82.0-89.7%), as determined by the modified response assessment criteria in solid tumors (mRECIST). The rates for complete response (CR) and partial response (PR) were 10.8% (95% CI, 5.0-16.6%) and 45.5% (95% CI, 38.0-53.0%), respectively. The median progression-free survival (mPFS) was 10.9 months, with a 95% confidence interval (CI) of 8.0 to 13.8. 91.0% (95% CI: 84.9-97.1%) of patients experienced adverse events (AEs) of any severity during therapy, with 24.8% (95% CI: 8.8-40.9%) reporting AEs of grade 3 or higher.
The A+B+TACE-HAIC therapy demonstrates promising efficacy and tolerance for the management of advanced HCC.
尽管阿替利珠单抗和贝伐珠单抗联合使用（A+B）对晚期肝细胞癌（HCC）显示出前景，但其缓解率仍不尽人意。先前的研究表明，基于FOLFOX的肝动脉灌注化疗（HAIC）与经动脉化疗栓塞术（TACE）相结合对HCC的治疗具有优势。本荟萃分析旨在评估A+B+TACE或HAIC治疗方案在晚期HCC患者中的安全性和疗效。
我们从PubMed、Cochrane图书馆、科学网和Embase等数据库收集了所有在2024年8月1日前发表的相关研究。我们使用Stata MP 14.0软件进行数据分析，纳入了数据提取和质量评估程序。
数据合成在某些情况下采用固定效应模型，在存在显著变异性的情况下采用随机效应模型。十项试验共纳入405例患者。根据实体瘤改良缓解评估标准（mRECIST）确定，总体客观缓解率（ORR）为57.2%（95%CI，46.9-67.6%），疾病控制率（DCR）为85.9%（95%CI，82.0-89.7%）。完全缓解（CR）率和部分缓解（PR）率分别为10.8%（95%CI，5.0-16.6%）和45.5%（95%CI，38.0-53.0%）。中位无进展生存期（mPFS）为10.9个月，95%置信区间（CI）为8.0至13.8。91.0%（95%CI：84.9-97.1%）的患者在治疗期间经历了任何严重程度的不良事件（AE），24.8%（95%CI：8.8-40.9%）报告了3级或更高等级的AE。
A+B+TACE-HAIC疗法在晚期HCC的治疗中显示出有前景的疗效和耐受性。
