Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Jun 1;26(6):1943-1952.
doi: 10.31557/APJCP.2025.26.6.1943.

Efficacy of Lenvatinib Versus Sorafenib in the Treatment of Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Ni Putu Sri Indrani Remitha  1 , Ni Putu Rista Pradnya Dewi  1 , I Komang Chandra Yogananda  1 , I Gede Aswin Parisya Sasmana  1 , I Komang Wira Ananta Kusuma  1 , I Gede Putu Supadmanaba  2 , Dwijo Anargha Sindhughosa  3 , I Ketut Mariadi  4
Affiliations
Meta-Analysis

Efficacy of Lenvatinib Versus Sorafenib in the Treatment of Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Ni Putu Sri Indrani Remitha et al. Asian Pac J Cancer Prev. .

Abstract

Introduction: Hepatocellular carcinoma (HCC) was the third leading cause of cancer-related deaths in the world. Current global treatment recommendations suggest lenvatinib and sorafenib have been approved to treat unresectable HCC. Studies comparing lenvatinib versus sorafenib for unresectable HCC have shown conflicting results and no structured review has yet evaluated its efficacy and safety. This article aims to estimate the efficacy of lenvatinib and sorafenib in patients with unresectable HCC.

Methods: This research was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) strategy. Literature searches were conducted through PubMed, ScienceDirect, Google Scholar, Cochrane Library, SpringerLink, and Ebsco. After quality assessment using the Newcastle-Ottawa Scale (NOS) and Cochrane Risk-of-bias, also data extraction, Review Manager 5.4 and RStudio 2024.04.1 software were used for analysis of overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR).

Results: A total of 9 studies were included, comprising 3,821 samples. All studies were retrospective studies. Our meta-analysis showed that OS and PFS in patients receiving lenvatinib were significantly better than patients receiving sorafenib with a protective hazard ratio (HR) of 0.70 (95%CI: 0.57-0.87, p=0.001) and 0.65 (95%CI: 0.54-0.78; p < 0.00001) respectively. Moreover, in the viral patients group, lenvatinib showed similar OS compared with sorafenib (HR=1.02; 95%CI: 0.77-1.36, p=0.87). Lenvatinib exhibited better ORR (OR = 7.87; 95%CI: 2.02-30.75; p = 0.003) and DCR (OR = 1.99; 95%CI: 1.53-2.60; p < 0.00001) compared with sorafenib.

Conclusion: Lenvatinib provided significant benefits in OS, PFS, ORR, and DCR compared to sorafenib in patients with unresectable HCC.

Keywords: Hepatocellular carcinoma; Lenvatinib; sorafenib.

PubMed Disclaimer

Conflict of interest statement

All authors declare there was no conflict of interest regarding this study.

Figures

Figure 1
Figure 1
PRISMA Flowchart
Figure 2
Figure 2
Forest Plot of Efficacy of Lenvatinib and Sorafenib in Patients with Unresectable HCC of Overall Survival (OS)
Figure 3
Figure 3
Forest Plot of Efficacy of Lenvatinib and Sorafenib in Patients with Unresectable HCC of Overall Survival (OS) of Viral Infection
Figure 4
Figure 4
Forest Plot of Efficacy of Lenvatinib and Sorafenib in Patients with Unresectable HCC of Progression-Free Survival (PFS)
Figure 5
Figure 5
Forest Plot of Efficacy of Lenvatinib and Sorafenib in Patients with Unresectable HCC of Objective Response Rate (ORR)
Figure 6
Figure 6
Forest Plot of Efficacy of Lenvatinib and Sorafenib in Patients with Unresectable HCC of Disease Control Rate (DCR)
Figure 7
Figure 7
Risk of Bias Assessment Using Cochrane Risk-of-bias Assessment Instrument for Randomized
Figure 8
Figure 8
Funnel Plots based on (A) OS, (B) OS of Viral Infection, (C) PFS, (D) ORR, (E) DCR
See this image and copyright information in PMC

References

    1. Ito T, Nguyen MH. Perspectives on the underlying etiology of HCC and its effects on treatment outcomes. J Hepatocell Carcinoma. 2023;10:413–28. - PMC - PubMed
    1. Llovet JM, Kelley RK, Villanueva A, Singal AG, Pikarsky E, Roayaie S, et al. Hepatocellular carcinoma. Nat Rev Dis Primers. 2021;7:1. - PubMed
    1. Ganne-Carrié N, Nahon P. Hepatocellular carcinoma in the setting of alcohol-related liver disease. J Hepatol. 2019;70(2):284–93. - PubMed
    1. Foglia B, Turato C, Cannito S. Hepatocellular carcinoma: Latest research in pathogenesis, detection and treatment. Int J Mol Sci. 2023;24(15):12224. - PMC - PubMed
    1. Leowattana W, Leowattana T, Leowattana PT. Systemic treatment for unresectable hepatocellular carcinoma. World J Gastroenterol. 2023;29(10):1551–68. - PMC - PubMed

MeSH terms