摘要
BACKGROUND Combination therapy has emerged as the focus of research for unresectable hepatocellular carcinoma(HCC).In recent years,several studies have explored the clinical efficacy and safety of the combination therapies of transarterial chemoembolization(TACE)with tyrosine kinase inhibitors(TKIs)and immune checkpoint inhibitors(ICIs).AIM To conduct an updated meta-analysis verifying the clinical benefits and adverse effects of the triple combination therapy for unresectable HCC.METHODS All eligible cohort,non-randomized controlled,and randomized controlled trial studies from the PubMed,Web of Science,Embase,Cochrane Library,and MedLine databases up to March 20,2024 were screened for the present metaanalysis.The study endpoints included complete response(CR),objective response rate(ORR),disease control rate(DCR),overall survival(OS),progressionfree survival(PFS),and adverse events(AEs).Stata 16/18 software was used for this meta-analysis,and a P value of<0.05 was considered statistically significant.RESULTS A total of 29 studies with 1754 patients were included.Among the patients who received the TACE therapy with TKIs and ICIs,the tumor response results revealed a pooled CR,ORR,and DCR of 14%[95%CI(0.11–0.18)],61%[95%CI(0.55–0.66)],and 85%[95%CI(0.83–0.87)],respectively.In terms of the survival outcomes,the pooled median PFS and OS were 10.25 months[95%CI(9.31–11.18)]and 20.47 months[95%CI(18.98–21.97)],respectively.The pooled prevalence of all-grade AEs during the triple treatment was 90%[95%CI(0.84–0.94)]and that of grade≥3 AEs was 32%[95%CI(0.24–0.42)].CONCLUSION The combination therapy of TACE,TKIs,and ICIs exhibits great clinical benefits for unresectable HCC in terms of tumor responses and survival outcomes without increasing the risk of severe AEs.
基金
Supported by Jiaxing Public Welfare Research Project,No.2022AD30046.
作者简介
Corresponding author:Chen-Zhou Xu,MM,Doctor,Department of Gastroenterology,The First Hospital of Jiaxing,The Affiliated Hospital of Jiaxing University,No.1882 Zhonghuan South Road,Jiaxing 314001,Zhejiang Province,China.jxsdyyyxcz@zjxu.edu.cn,009-0009-9227-7210.
