Molecular targeted therapy and immunotherapy in advanced hepatocellular carcinoma: a systematic review and Bayesian network meta-analysis based on randomized controlled trials

Yun-Long Zhang; Xin-Jiang Cui; Hui Xing; Hou-Fa Ning; Peng Dong; Guang-Zhi Wang

doi:10.1080/07853890.2023.2242384

Molecular targeted therapy and immunotherapy in advanced hepatocellular carcinoma: a systematic review and Bayesian network meta-analysis based on randomized controlled trials

Ann Med. 2023;55(2):2242384. doi: 10.1080/07853890.2023.2242384.

Authors

Yun-Long Zhang^{1

2}, Xin-Jiang Cui³, Hui Xing³, Hou-Fa Ning³, Peng Dong^{1

2}, Guang-Zhi Wang^{1

2}

Affiliations

¹ School of Medical Imaging, Weifang Medical University, Weifang, Shandong, China.
² Department of Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China.
³ Department of Vascular and Interventional Radiology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China.

Abstract

Objective: The aim of this study was to compare and rank different targeted therapies or immunotherapies for advanced hepatocellular carcinoma based on efficacy.

Methods: A systematic search of the PubMed, EMBASE, and Cochrane Library databases was conducted. All systematic treatment regimens that reported comparisons with sorafenib were included in this analysis. The primary outcome measures were overall survival (OS) and progression-free survival (PFS), and other outcome measures included the objective response rate (ORR) and safety analysis according to reported treatment-related adverse events.

Results: A total of 29 RCTs involving 13376 patients were included in the analysis, including 10 single-agent therapies and 17 combination therapies. Compared with sorafenib, sintilimab plus IBI305 (HR: 0.57, 95% CI: 0.43-0.75), camrelizumab plus rivoceranib (HR: 0.62, 95% CI: 0.49-0.78), and atezolizumab plus bevacizumab (HR: 0.66, 95% CI: 0.52-0.83) ranked in the top three in terms of OS.

Conclusions: PD-1/PD-L1 inhibitors combined with anti-vascular endothelial growth factor (anti-VEGF)-targeting drugs have shown better therapeutic effects in the systematic treatment of patients with advanced hepatocellular carcinoma, and the combination of targeted and immune therapy modes should be further developed.

Keywords: Bayesian; Molecular targeted therapy; hepatocellular carcinoma; immunotherapy; meta-analysis.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Bayes Theorem
Carcinoma, Hepatocellular* / drug therapy
Carcinoma, Hepatocellular* / pathology
Humans
Immunotherapy
Liver Neoplasms* / drug therapy
Liver Neoplasms* / pathology
Molecular Targeted Therapy
Network Meta-Analysis
Randomized Controlled Trials as Topic
Sorafenib / therapeutic use

Substances

Sorafenib

Grants and funding

This study was supported in part by grants from the Medical and Health Science and Technology Development Project of Shandong Province (No. 2019WS596), and the Natural Science Foundation of Shandong Province (No. ZR2020MH293).