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Review
. 2022 Nov 10;14(22):5525.
doi: 10.3390/cancers14225525.

Lenvatinib as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Shijie Wang  1   2 , Yiting Wang  3 , Jiangtao Yu  4 , Huaxing Wu  1 , Yanming Zhou  1
Affiliations
Review

Lenvatinib as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Shijie Wang et al. Cancers (Basel). .

Abstract

Lenvatinib was approved in 2018 as a first-line treatment for patients with unresectable hepatocellular carcinoma (HCC). This systematic review and meta-analysis aimed to provide the most updated evidence about the efficacy and safety of lenvatinib as a first-line treatment for unresectable HCC. An electronic search of the PubMed database, Web of Science, Embase, and Cochrane Library was undertaken to identify all relevant studies up to May 2022. The pooled effect sizes were calculated based on the random-effects model. One phase III randomized controlled trial and 23 retrospective studies of 2438 patients were eligible for analysis. For patients treated with lenvatinib as first-line treatment, the pooled median overall survival (OS), median progression-free survival (PFS), 1-year OS rate, 1-year PFS rate, objective response rate (ORR), and disease control rate (DCR) were 11.36 months, 6.68 months, 56.0%, 27.0%, 36.0% and 75.0%, respectively. Lenvatinib showed a significantly superior efficacy compared with sorafenib (HR for OS, 0.85 and HR for PFS, 0.72; OR for ORR, 4.25 and OR for DCR, 2.23). The current study demonstrates that lenvatinib can provide better tumor responses and survival benefits than sorafenib as a first-line treatment for unresectable HCC, with a comparable incidence of adverse events.

Keywords: hepatocellular carcinoma; lenvatinib; meta-analysis; review; sorafenib.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the selection process.
Figure 2
Figure 2
The median OS (A) and median PFS (B) of lenvatinib in the treatment of unresectable hepatocellular carcinoma.
Figure 3
Figure 3
The 1-year OS rate (A) and 1-year PFS rate (B) of lenvatinib for unresectable hepatocellular carcinoma.
Figure 4
Figure 4
The ORR (A) and DCR (B) of lenvatinib for unresectable hepatocellular carcinoma.
Figure 5
Figure 5
Forest plots of the OS (A) and PFS (B) associated with lenvatinib vs. sorafenib.
Figure 6
Figure 6
Forest plots of the ORR (A) and DCR (B) associated with lenvatinib vs. sorafenib.
Figure 7
Figure 7
Forest plots of the all-grade (A) and severe adverse events (B) associated with lenvatinib vs. sorafenib.
See this image and copyright information in PMC

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