PMID- 30214225
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 1178-6930 (Print)
IS  - 1178-6930 (Electronic)
IS  - 1178-6930 (Linking)
VI  - 11
DP  - 2018
TI  - Alternative treatment strategies to sorafenib in patients with advanced 
      hepatocellular carcinoma: a meta-analysis of randomized Phase III trials.
PG  - 5195-5201
LID - 10.2147/OTT.S171918 [doi]
AB  - INTRODUCTION: This meta-analysis was conducted to evaluate efficacy and safety in 
      patients treated with sorafenib vs other tyrosine-kinase inhibitors (TKIs) or 
      selective internal radiotherapy (SIRT) for advanced hepatocellular carcinoma 
      (HCC). METHODS: Electronic databases were systematically reviewed for randomized 
      Phase III trials comparing sorafenib with other TKIs or SIRT in advanced HCC. 
      Sorafenib was defined as the control arm. Other TKIs or SIRT was defined as the 
      experimental arm. Overall survival (OS), time to progression (TTP), objective 
      response rate (ORR), disease-control rate (DCR), and adverse events (AEs) were 
      reviewed. Four trials in the other-TKI group (n=4,218) and two in the SIRT group 
      (n=819) were eligible. RESULTS: Compared with sorafenib, other TKIs showed 
      similar benefit on OS (HR 1.08, 95% CI 0.93-1.24; P=0.31) and TTP (HR 0.86, 95% 
      CI 0.66-1.12; P=0.26) for advanced HCC. A significant increase in ORR (RR 1.67, 
      95% CI 1.15-2.43; P=0.008) was found with other TKIs, but no increase in DCR (RR 
      1.11, 95% CI 0.98-1.26; P=0.11) was observed. Other TKIs were associated with 
      more frequent grade 3/4 AEs than sorafenib, including hypertension (P<0.00001), 
      thrombocytopenia (P=0.002), fatigue (P<0.00001), decreased appetite (P<0.00001), 
      and vomiting (P<0.0001). For locally advanced HCC, neither OS (HR 1.14, 95% CI 
      0.98-1.32; P=0.09) nor TTP (HR 0.87, 95% CI 0.74-1.02; P=0.10) differed 
      significantly in SIRT and sorafenib. There was an increase in ORR (RR 2.60, 95% 
      CI 1.69-4.00; P<0.0001), but no improvement in DCR (RR 0.91, 95% CI 0.81-1.02; 
      P=0.11) in the SIRT group. Fewer patients treated with SIRT had grade 3/4 AEs 
      than those treated with sorafenib, including diarrhea (P<0.0001), fatigue 
      (P=0.0006), and hand-foot syndrome (P=0.0002). Other TKIs were noninferior to 
      sorafenib in OS and TTP in advanced HCC, but with increased risk of toxicities. 
      CONCLUSION: Patients with locally advanced HCC treated with SIRT got similar 
      efficacy with less toxicity to those treated with sorafenib.
FAU - Wang, Hui
AU  - Wang H
AD  - Department of Radiation Oncology, Yancheng First People's Hospital, Yancheng, 
      Jiangsu 224005, China, 1119159361@qq.com.
FAU - Wang, Hefang
AU  - Wang H
AD  - Department of Radiation Oncology, Yancheng First People's Hospital, Yancheng, 
      Jiangsu 224005, China, 1119159361@qq.com.
FAU - Yu, Zhichong
AU  - Yu Z
AD  - Department of Radiation Oncology, Yancheng First People's Hospital, Yancheng, 
      Jiangsu 224005, China, 1119159361@qq.com.
FAU - Liu, Honghao
AU  - Liu H
AD  - Department of Radiation Oncology, Yancheng First People's Hospital, Yancheng, 
      Jiangsu 224005, China, 1119159361@qq.com.
LA  - eng
PT  - Journal Article
DEP - 20180827
PL  - New Zealand
TA  - Onco Targets Ther
JT  - OncoTargets and therapy
JID - 101514322
PMC - PMC6118246
OTO - NOTNLM
OT  - hepatocellular carcinoma
OT  - meta-analysis
OT  - selective internal radiotherapy
OT  - sorafenib
OT  - tyrosine-kinase inhibitors
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2018/09/15 06:00
MHDA- 2018/09/15 06:01
PMCR- 2018/08/27
CRDT- 2018/09/15 06:00
PHST- 2018/09/15 06:00 [entrez]
PHST- 2018/09/15 06:00 [pubmed]
PHST- 2018/09/15 06:01 [medline]
PHST- 2018/08/27 00:00 [pmc-release]
AID - ott-11-5195 [pii]
AID - 10.2147/OTT.S171918 [doi]
PST - epublish
SO  - Onco Targets Ther. 2018 Aug 27;11:5195-5201. doi: 10.2147/OTT.S171918. 
      eCollection 2018.