Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis
IntroductionTo investigate the effects of hepatic arterial infusion chemotherapy (HAIC) with or without systemic chemotherapy compared to systemic chemotherapy alone in patients with locally advanced hepatocellular carcinoma (HCC).MethodsFollowing a registered protocol (PROSPERO 2023 CRD42023386780...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1265240/full |
| _version_ | 1797662942035968000 |
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| author | Hyeon-Jong Kim Seung Hyuk Lee Hyun Jeong Shim Hyun Jin Bang Sang Hee Cho Ik-Joo Chung Eu Chang Hwang Jun Eul Hwang Woo Kyun Bae |
| author_facet | Hyeon-Jong Kim Seung Hyuk Lee Hyun Jeong Shim Hyun Jin Bang Sang Hee Cho Ik-Joo Chung Eu Chang Hwang Jun Eul Hwang Woo Kyun Bae |
| author_sort | Hyeon-Jong Kim |
| collection | DOAJ |
| description | IntroductionTo investigate the effects of hepatic arterial infusion chemotherapy (HAIC) with or without systemic chemotherapy compared to systemic chemotherapy alone in patients with locally advanced hepatocellular carcinoma (HCC).MethodsFollowing a registered protocol (PROSPERO 2023 CRD42023386780 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023386780), a comprehensive search was performed using reputable databases and registries up to December 26, 2022, with no language, publication date, or status restrictions. Only randomized controlled trials (RCTs) investigating the effects of HAIC with or without systemic chemotherapy versus systemic therapy alone were included. The primary outcomes were overall survival (OS), progression-free survival (PFS), and adverse events. The secondary outcomes included the objective response rate (ORR) and disease control rate (DCR). A random-effects model was used, and the certainty of the evidence was rated using GRADE.ResultsSeven RCTs involving 1,010 patients were included. All trials utilized sorafenib as the comparator. Five trials (690 patients) compared HAIC plus sorafenib to sorafenib alone, while two trials (320 patients) compared HAIC to sorafenib. The results indicate that HAIC, with or without sorafenib, may increase OS, PFS, and ORR compared with sorafenib alone. HAIC may enhance DCR, but the evidence is very uncertain. Adverse events were comparable between HAIC plus sorafenib and sorafenib alone. However, adverse events might be decreased in HAIC alone.DiscussionHAIC with or without systemic chemotherapy may improve survival outcomes and response rates of patients with HCC. Since the current body of evidence is moderate to very low, more robust randomized trials are needed to confirm the efficacy of HAIC.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=386780, identifier CRD42023386780. |
| first_indexed | 2024-03-11T19:07:24Z |
| format | Article |
| id | doaj.art-96132905f7c64103bdf179e1faaf17ad |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-11T19:07:24Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-96132905f7c64103bdf179e1faaf17ad2023-10-10T06:58:26ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-10-011310.3389/fonc.2023.12652401265240Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysisHyeon-Jong Kim0Seung Hyuk Lee1Hyun Jeong Shim2Hyun Jin Bang3Sang Hee Cho4Ik-Joo Chung5Eu Chang Hwang6Jun Eul Hwang7Woo Kyun Bae8Division of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaDepartment of Urology, Chonnam National University Medical School, Hwasun, Republic of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaDivision of Hematology-Oncology, Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of KoreaIntroductionTo investigate the effects of hepatic arterial infusion chemotherapy (HAIC) with or without systemic chemotherapy compared to systemic chemotherapy alone in patients with locally advanced hepatocellular carcinoma (HCC).MethodsFollowing a registered protocol (PROSPERO 2023 CRD42023386780 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023386780), a comprehensive search was performed using reputable databases and registries up to December 26, 2022, with no language, publication date, or status restrictions. Only randomized controlled trials (RCTs) investigating the effects of HAIC with or without systemic chemotherapy versus systemic therapy alone were included. The primary outcomes were overall survival (OS), progression-free survival (PFS), and adverse events. The secondary outcomes included the objective response rate (ORR) and disease control rate (DCR). A random-effects model was used, and the certainty of the evidence was rated using GRADE.ResultsSeven RCTs involving 1,010 patients were included. All trials utilized sorafenib as the comparator. Five trials (690 patients) compared HAIC plus sorafenib to sorafenib alone, while two trials (320 patients) compared HAIC to sorafenib. The results indicate that HAIC, with or without sorafenib, may increase OS, PFS, and ORR compared with sorafenib alone. HAIC may enhance DCR, but the evidence is very uncertain. Adverse events were comparable between HAIC plus sorafenib and sorafenib alone. However, adverse events might be decreased in HAIC alone.DiscussionHAIC with or without systemic chemotherapy may improve survival outcomes and response rates of patients with HCC. Since the current body of evidence is moderate to very low, more robust randomized trials are needed to confirm the efficacy of HAIC.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=386780, identifier CRD42023386780.https://www.frontiersin.org/articles/10.3389/fonc.2023.1265240/fullintra-arterial infusionscarcinomahepatocellular carcinomadrug therapysurvivalGRADE approach (MeSH) |
| spellingShingle | Hyeon-Jong Kim Seung Hyuk Lee Hyun Jeong Shim Hyun Jin Bang Sang Hee Cho Ik-Joo Chung Eu Chang Hwang Jun Eul Hwang Woo Kyun Bae Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis Frontiers in Oncology intra-arterial infusions carcinoma hepatocellular carcinoma drug therapy survival GRADE approach (MeSH) |
| title | Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis |
| title_full | Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis |
| title_fullStr | Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis |
| title_full_unstemmed | Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis |
| title_short | Hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma: a systematic review and meta-analysis |
| title_sort | hepatic arterial infusion chemotherapy versus systemic therapy for advanced hepatocellular carcinoma a systematic review and meta analysis |
| topic | intra-arterial infusions carcinoma hepatocellular carcinoma drug therapy survival GRADE approach (MeSH) |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1265240/full |
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