Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysis
Abstract Background Transarterial therapies, including transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy, combined with first-line tyrosine kinase inhibitors (TKIs) are considered the standard therapy for unresectable hepa...
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03098-3 |
| _version_ | 1827895077391826944 |
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| author | Lingbo Hu Jiangying Lin Xingpeng Shi Aidong Wang |
| author_facet | Lingbo Hu Jiangying Lin Xingpeng Shi Aidong Wang |
| author_sort | Lingbo Hu |
| collection | DOAJ |
| description | Abstract Background Transarterial therapies, including transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy, combined with first-line tyrosine kinase inhibitors (TKIs) are considered the standard therapy for unresectable hepatocellular carcinoma. However, inconsistent results have been reported in various studies assessing different combinations of targeted agents. Methods A network meta-analysis (NMA) was performed by including 23 randomized controlled trials (RCTs) with 6175 patients to investigate the efficiency of transarterial therapies in combination with different TKIs. Outcomes of interest included overall survival (OS), progression-free survival (PFS), time to progression (TTP), and tumor objective response rate (ORR). A random-effects consistency model was used in this Bayesian NMA. Hazard ratio and odd risks with a 95% credible interval were calculated and agents were ranked based on ranking probability. Results HAIC showed maximal OS and TTP and TACE plus lenvatinib showed maximal PFS, ORR, and disease control rate (DCR). HAIC and TACE plus lenvatinib were ranked highest based on their respective parameters, which were OS for HAIC and PFS, ORR, and DCR for TACE plus lenvatinib. Conclusion HAIC and TACE plus lenvatinib were relatively better choice for unresectable hepatocellular carcinoma. However, owing to the lack of statistically significant OS benefits among most agents, other agents should be considered as potential alternatives for unresectable hepatocellular carcinoma. |
| first_indexed | 2024-03-12T22:16:29Z |
| format | Article |
| id | doaj.art-07e0a8385a0d44d4a635355ced0952b8 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-12T22:16:29Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-07e0a8385a0d44d4a635355ced0952b82023-07-23T11:16:18ZengBMCWorld Journal of Surgical Oncology1477-78192023-07-0121111410.1186/s12957-023-03098-3Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysisLingbo Hu0Jiangying Lin1Xingpeng Shi2Aidong Wang3Department of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Blood Purification, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityDepartment of Hepatopancreatobiliary Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityAbstract Background Transarterial therapies, including transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy, combined with first-line tyrosine kinase inhibitors (TKIs) are considered the standard therapy for unresectable hepatocellular carcinoma. However, inconsistent results have been reported in various studies assessing different combinations of targeted agents. Methods A network meta-analysis (NMA) was performed by including 23 randomized controlled trials (RCTs) with 6175 patients to investigate the efficiency of transarterial therapies in combination with different TKIs. Outcomes of interest included overall survival (OS), progression-free survival (PFS), time to progression (TTP), and tumor objective response rate (ORR). A random-effects consistency model was used in this Bayesian NMA. Hazard ratio and odd risks with a 95% credible interval were calculated and agents were ranked based on ranking probability. Results HAIC showed maximal OS and TTP and TACE plus lenvatinib showed maximal PFS, ORR, and disease control rate (DCR). HAIC and TACE plus lenvatinib were ranked highest based on their respective parameters, which were OS for HAIC and PFS, ORR, and DCR for TACE plus lenvatinib. Conclusion HAIC and TACE plus lenvatinib were relatively better choice for unresectable hepatocellular carcinoma. However, owing to the lack of statistically significant OS benefits among most agents, other agents should be considered as potential alternatives for unresectable hepatocellular carcinoma.https://doi.org/10.1186/s12957-023-03098-3Transarterial chemoembolizationHepatic arterial infusion chemotherapySelective internal radiation therapyTyrosine kinase inhibitorsHepatocellular carcinomaNetwork meta-analysis |
| spellingShingle | Lingbo Hu Jiangying Lin Xingpeng Shi Aidong Wang Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysis World Journal of Surgical Oncology Transarterial chemoembolization Hepatic arterial infusion chemotherapy Selective internal radiation therapy Tyrosine kinase inhibitors Hepatocellular carcinoma Network meta-analysis |
| title | Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysis |
| title_full | Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysis |
| title_fullStr | Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysis |
| title_full_unstemmed | Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysis |
| title_short | Efficacy of transarterial therapy combined with first-line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma: a network meta-analysis |
| title_sort | efficacy of transarterial therapy combined with first line tyrosine kinase inhibitors for unresectable hepatocellular carcinoma a network meta analysis |
| topic | Transarterial chemoembolization Hepatic arterial infusion chemotherapy Selective internal radiation therapy Tyrosine kinase inhibitors Hepatocellular carcinoma Network meta-analysis |
| url | https://doi.org/10.1186/s12957-023-03098-3 |
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