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. 2025 Feb 15;17(2):98927.
doi: 10.4251/wjgo.v17.i2.98927.

Efficacy of sorafenib combined with transarterial chemoembolization in the treatment of advanced hepatocellular carcinoma: A meta-analysis

Mei Xu  1 , Si-Rui Zhou  1 , Ya-Ling Li  2 , Chen-Hao Zhang  3 , Da-Zhong Liao  1 , Xiao-Li Wang  4
Affiliations

Efficacy of sorafenib combined with transarterial chemoembolization in the treatment of advanced hepatocellular carcinoma: A meta-analysis

Mei Xu et al. World J Gastrointest Oncol. .

Abstract

Background: The combination of sorafenib with transarterial chemoembolization (TACE) is being investigated for its potential to improve outcomes in advanced hepatocellular carcinoma (HCC).

Aim: To evaluate the efficacy of this combined treatment strategy in enhancing overall survival (OS) and progression-free survival (PFS) compared to monotherapies.

Methods: A systematic review was conducted following the PRISMA guidelines. A comprehensive search was performed across PubMed, EMBASE, Web of Science, and the Cochrane Library up to May 8, 2024. Studies were included if they compared sorafenib plus TACE to sorafenib alone or TACE alone in adults with advanced HCC. Primary outcomes were OS, PFS, response rates, and safety profiles. Data extraction and quality assessment were independently performed by two reviewers. Heterogeneity was assessed using the I² statistic, and a random-effects model was applied for pooling data. Sensitivity analysis and publication bias assessment were also conducted.

Results: A total of twelve studies involving 1174 patients met the inclusion criteria. Significant heterogeneity was observed for both OS (I² = 72.6%, P < 0.001) and PFS (I² = 83.7%, P < 0.001). The combined treatment of sorafenib with TACE significantly improved OS [hazard ratio (HR) = 0.60, 95% confidence interval (CI): 0.44-0.76] and PFS (HR = 0.54, 95%CI: 0.38-0.69). Sensitivity analysis confirmed the robustness of these findings. Funnel plots and Egger's test indicated no significant publication bias.

Conclusion: Sorafenib combined with TACE significantly enhances both OS and PFS in patients with advanced HCC compared to monotherapy. This combination therapy represents a promising approach to improving clinical outcomes in advanced liver cancer.

Keywords: Hepatocellular carcinoma; Meta-analysis; Overall survival; Progression-free survival; Sorafenib; Transarterial chemoembolization.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Study selection flow diagram for the meta-analysis.
Figure 2
Figure 2
Risk of bias evaluation for included studies, depicted with red indicating high risk and green indicating low risk.
Figure 3
Figure 3
Forest plot showing the impact of combining sorafenib with transarterial chemoembolization on overall survival.
Figure 4
Figure 4
Forest plot displaying the benefits of sorafenib and transarterial chemoembolization combination on progression-free survival.
Figure 5
Figure 5
Sensitivity analysis graphs confirming the stability of the meta-analysis results for overall survival and progression-free survival. A: Overall survival; B: Progression-free survival.
Figure 6
Figure 6
Funnel plot for evaluation of publication bias in the meta-analysis.
See this image and copyright information in PMC

References

    1. Ganesan P, Kulik LM. Hepatocellular Carcinoma: New Developments. Clin Liver Dis. 2023;27:85–102. - PubMed
    1. Gilles H, Garbutt T, Landrum J. Hepatocellular Carcinoma. Crit Care Nurs Clin North Am. 2022;34:289–301. - PubMed
    1. Galle PR, Dufour JF, Peck-Radosavljevic M, Trojan J, Vogel A. Systemic therapy of advanced hepatocellular carcinoma. Future Oncol. 2021;17:1237–1251. - PubMed
    1. Yau T, Park JW, Finn RS, Cheng AL, Mathurin P, Edeline J, Kudo M, Harding JJ, Merle P, Rosmorduc O, Wyrwicz L, Schott E, Choo SP, Kelley RK, Sieghart W, Assenat E, Zaucha R, Furuse J, Abou-Alfa GK, El-Khoueiry AB, Melero I, Begic D, Chen G, Neely J, Wisniewski T, Tschaika M, Sangro B. Nivolumab versus sorafenib in advanced hepatocellular carcinoma (CheckMate 459): a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol. 2022;23:77–90. - PubMed
    1. Dahiya M, Dureja H. Sorafenib for hepatocellular carcinoma: potential molecular targets and resistance mechanisms. J Chemother. 2022;34:286–301. - PubMed

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