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Review
. 2024 Aug 22:14:1364345.
doi: 10.3389/fonc.2024.1364345. eCollection 2024.

Efficacy and safety of PD-1 inhibitors plus anti-angiogenesis tyrosine kinase inhibitors with or without transarterial chemo(embolization) for unresectable hepatocellular carcinoma: a meta-analysis

Yue Chen  1 , Luyao Jia  1 , Yu Li  1 , Wenhao Cui  2 , Jukun Wang  1 , Chao Zhang  1 , Chunjing Bian  1 , Tao Luo  1
Affiliations
Review

Efficacy and safety of PD-1 inhibitors plus anti-angiogenesis tyrosine kinase inhibitors with or without transarterial chemo(embolization) for unresectable hepatocellular carcinoma: a meta-analysis

Yue Chen et al. Front Oncol. .

Abstract

Background: The triple combination of programmed cell death protein-1 (PD-1) inhibitors plus anti-angiogenesis tyrosine kinase inhibitors (TKIs) with or without transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) enhance the effect of treatment for unresectable hepatocellular carcinoma (uHCC). The present study compared the efficacy and safety of PD-1 plus TKI with or without transarterial chemo(embolization) for uHCC.

Methods: The meta-analysis was conducted using data acquired from PubMed, EMBASE, the Cochrane Library, Ovid, Web of Science, and Clinical Trials.gov from the inception date to December 2023. All clinical outcomes of interest included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). The hazard ratio (HR) and risk ratio (RR) with 95% confidence intervals (CIs) were used to measure the pooled effect. In addition, subgroup analysis was conducted to determine the specific patient population that benefited.

Results: The OS (HR = 0.47; 95% CI: 0.39-0.56, P < 0.05), PFS (HR = 0.52; 95% CI: 0.45-0.60, P < 0.05), and ORR (RR = 1.94; 95% CI: 1.60-2.35, P < 0.05) were significantly better in TACE/HAIC+TKI+PD-1(TACE/HAIC TP) group than TKI+PD-1(TP) group. The incidence of AEs was acceptable.

Conclusion: The triple therapy of TACE/HAIC TP had better efficacy for uHCC than TP, with acceptable security.

Systematic review registration: PROSPERO, identifier CRD42023475953.

Keywords: PD-1 inhibitors; hepatic artery infusion chemotherapy; transarterial chemoembolization; tyrosine kinase inhibitors; unresectable hepatocellular carcinoma.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of article screening and selection process.
Figure 2
Figure 2
Forest plot about the pooled results of TACE/HAIC TP versus TP for unresectable HCC. Outcome: OS (A), PFS (B), and ORR (C) in total.
Figure 3
Figure 3
Forest plot about the pooled results of TACE TP versus HIAC TP for unresectable HCC. Outcome: OS (A), PFS (B), and ORR (C) in total.
See this image and copyright information in PMC

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