PMID- 34297207
OWN - NLM
STAT- MEDLINE
DCOM- 20220420
LR  - 20220909
IS  - 1432-1335 (Electronic)
IS  - 0171-5216 (Linking)
VI  - 148
IP  - 5
DP  - 2022 May
TI  - The efficacy of immune checkpoint inhibitors in advanced hepatocellular 
      carcinoma: a meta-analysis based on 40 cohorts incorporating 3697 individuals.
PG  - 1195-1210
LID - 10.1007/s00432-021-03716-1 [doi]
AB  - BACKGROUND: This study was designed to investigate the efficacy and safety of 
      immune checkpoint inhibitors (ICIs) in advanced hepatocellular carcinoma (HCC). 
      METHODS: Electronic databases were scanned to identify relevant trials. The 
      primary endpoints were overall survival (OS), progression-free survival (PFS), 
      and their prognostic factors. Stratified analyses were accomplished on ICIs agent 
      and evaluation criteria. RESULTS: Totally, 3697 individuals from 40 cohorts were 
      recruited. For patients treated with ICIs, the pooled median time to progression 
      (TTP) was 8.0 months, median PFS 4.9 months, and median OS 12.0 months; the 
      pooled median PFS and OS of ICIs plus anti-vascular endothelial growth factor 
      (VEGF) agents (PFS: 6.3 months, OS: 16.4 months) were longer than those of ICIs 
      alone. Furthermore, Child-Pugh stage (HR = 1.37, P = 0.0123) and Eastern 
      Cooperative Oncology Group (ECOG) (HR = 1.40, P = 0.0016) were prognostic factors 
      for PFS. Hepatitis C virus (HCV) (HR = 0.71, P = 0.0356), Alpha-fetoprotein (AFP) 
      (HR = 1.17, P < 0.0001), Child-Pugh stage (HR = 1.58, P < 0.0001), Barcelona 
      Clinic Liver Cancer (BCLC) stage (HR = 1.23, P = 0.0005), ECOG (HR = 1.50, 
      P = 0.0012), portal vein invasion (HR = 1.32, P = 0.0053), extrahepatic 
      metastasis (HR = 0.84, P = 0.0047), best response (HR = 0.58, P < 0.0001), and 
      neutrophil-to-lymphocyte ratio (NLR) (HR = 1.23, P = 0.0451) were the prognostic 
      factors for OS. According to both RECIST 1.1 and mRECIST, the objective response 
      rate (ORR) and disease control rate (DCR) rate of ICIs plus anti-VEGF agents were 
      better than those of ICIs alone. The overall rate of any grade adverse events 
      (AEs) was 0.76 (95% CI 0.61-0.89), grade 3 or higher AEs was 0.28 (95% CI 
      0.15-0.42), and the rate of AEs leading to treatment discontinuation was 0.09 
      (95% CI 0.06-0.12). CONCLUSIONS: The ICIs was promising in HCC with good efficacy 
      and tolerated toxicity. Compared with ICIs monotherapy, the joint application of 
      ICIs and anti-VEGF agents can contribute a lot more benefits to the survival of 
      patients according to clinical practices.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Wang, Rixiong
AU  - Wang R
AD  - Department of Oncology, Molecular Oncology Research Institute, The First 
      Affiliated Hospital, Fujian Medical University, Chazhong Road No. 20, Fuzhou, 
      350005, Fujian, China.
FAU - Lin, Nan
AU  - Lin N
AD  - Department of General Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, 
      350005, Fujian, China.
FAU - Mao, Binbin
AU  - Mao B
AD  - Department of Oncology, Molecular Oncology Research Institute, The First 
      Affiliated Hospital, Fujian Medical University, Chazhong Road No. 20, Fuzhou, 
      350005, Fujian, China.
FAU - Wu, Qing
AU  - Wu Q
AUID- ORCID: 0000-0001-8781-109X
AD  - Department of Oncology, Molecular Oncology Research Institute, The First 
      Affiliated Hospital, Fujian Medical University, Chazhong Road No. 20, Fuzhou, 
      350005, Fujian, China. wuqing@fjmu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20210723
PL  - Germany
TA  - J Cancer Res Clin Oncol
JT  - Journal of cancer research and clinical oncology
JID - 7902060
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - *Carcinoma, Hepatocellular/drug therapy
MH  - Humans
MH  - Immune Checkpoint Inhibitors/therapeutic use
MH  - *Liver Neoplasms/drug therapy
MH  - Progression-Free Survival
OTO - NOTNLM
OT  - Efficacy
OT  - Hepatocellular carcinoma
OT  - Immune checkpoint inhibitors
OT  - Safety
EDAT- 2021/07/24 06:00
MHDA- 2022/04/21 06:00
CRDT- 2021/07/23 12:26
PHST- 2021/02/28 00:00 [received]
PHST- 2021/06/25 00:00 [accepted]
PHST- 2021/07/24 06:00 [pubmed]
PHST- 2022/04/21 06:00 [medline]
PHST- 2021/07/23 12:26 [entrez]
AID - 10.1007/s00432-021-03716-1 [pii]
AID - 10.1007/s00432-021-03716-1 [doi]
PST - ppublish
SO  - J Cancer Res Clin Oncol. 2022 May;148(5):1195-1210. doi: 
      10.1007/s00432-021-03716-1. Epub 2021 Jul 23.