PMID- 36620586
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230111
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - Efficacy and safety of lenvatinib versus sorafenib in first-line treatment of 
      advanced hepatocellular carcinoma: A meta-analysis.
PG  - 1010726
LID - 10.3389/fonc.2022.1010726 [doi]
LID - 1010726
AB  - OBJECTIVE: Lenvatinib and sorafenib are first-line oral multikinase inhibitors 
      approved for the treatment of advanced hepatocellular carcinoma (HCC). However, 
      the choice of the primary therapeutic agent among these two remains 
      controversial. This meta-analysis aimed to estimate the efficacy and safety of 
      lenvatinib and sorafenib in patients with advanced HCC. METHODS: PubMed, Cochrane 
      Library, Web of Science, and Embase databases were searched for relevant research 
      published up to June 30, 2022. After quality assessment and data extraction of 
      the included studies, RevMan 5.3 software was used for analysis. Odds ratio (OR) 
      and hazard ratio (HR) with a 95% confidence interval (CI) were calculated using a 
      fixed-effects or random-effects model. RESULTS: Fifteen studies containing 3908 
      patients were included after final scrutiny. Our meta-analysis showed that there 
      was no significant difference in overall survival (OS) between the lenvatinib and 
      sorafenib groups (HR = 0.86; 95% CI: 0.72-1.02; p = 0.09); however, the 
      progression-free survival (PFS) (HR = 0.63; 95% CI: 0.53-0.74; p < 0.00001), 
      complete response (CR) (OR = 5.61; 95% CI: 2.71-11.64; p < 0.00001), partial 
      response (PR) (OR = 4.62; 95% CI: 3.06-6.98; p < 0.00001), objective response 
      rate (ORR) (OR = 5.61; 95% CI: 3.90-8.09; p < 0.00001), and disease control rate 
      (DCR) (OR = 2.42; 95% CI: 1.79-3.28; p < 0.00001) in the lenvatinib group were 
      significantly better than those in the sorafenib group. In terms of treatment 
      safety, lenvatinib had similar incidences of any grade adverse events (AEs) (OR = 
      0.99; 95% CI: 0.47-2.09; p = 0.98) and grade >/= 3 AEs (OR = 1.17, 95% CI; 
      1.00-1.37; p = 0.05) compared to sorafenib. Besides, lenvatinib was significantly 
      associated with a higher incidence of hypertension, proteinuria, fatigue, 
      decreased appetite, and weight loss, whereas sorafenib was associated with a 
      higher incidence of diarrhea and hand-foot skin reaction (p < 0.05). CONCLUSION: 
      Given its potential survival benefit and good tolerability, lenvatinib is an 
      appropriate and promising alternative to sorafenib as first-line systemic therapy 
      in patients with advanced HCC. SYSTEMATIC REVIEW REGISTRATION: 
      https://www.crd.york.ac.uk/prospero/, identifier: CRD 42022327398.
CI  - Copyright (c) 2022 Luo, Gao, Lin, Fan, Ma, Yu, Yang, Tian, Yang and Li.
FAU - Luo, Jia
AU  - Luo J
AD  - Department of Oncology and Hematology, People's Hospital of Leshan, Leshan, 
      China.
FAU - Gao, Benjian
AU  - Gao B
AD  - Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of 
      Southwest Medical University, Luzhou, China.
AD  - Academician (Expert) Workstation of Sichuan Province, Luzhou, China.
FAU - Lin, Zhiyu
AU  - Lin Z
AD  - Department of Oncology and Hematology, People's Hospital of Leshan, Leshan, 
      China.
FAU - Fan, Hua
AU  - Fan H
AD  - Department of Oncology and Hematology, People's Hospital of Leshan, Leshan, 
      China.
FAU - Ma, Wen
AU  - Ma W
AD  - Department of Oncology and Hematology, People's Hospital of Leshan, Leshan, 
      China.
FAU - Yu, Danfei
AU  - Yu D
AD  - Department of Oncology and Hematology, People's Hospital of Leshan, Leshan, 
      China.
FAU - Yang, Qian
AU  - Yang Q
AD  - Department of Oncology and Hematology, People's Hospital of Leshan, Leshan, 
      China.
FAU - Tian, Jing
AU  - Tian J
AD  - Department of Oncology and Hematology, People's Hospital of Leshan, Leshan, 
      China.
FAU - Yang, Xiaoli
AU  - Yang X
AD  - Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of 
      Southwest Medical University, Luzhou, China.
AD  - Academician (Expert) Workstation of Sichuan Province, Luzhou, China.
FAU - Li, Bo
AU  - Li B
AD  - Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of 
      Southwest Medical University, Luzhou, China.
AD  - Academician (Expert) Workstation of Sichuan Province, Luzhou, China.
LA  - eng
PT  - Systematic Review
DEP - 20221222
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9814719
OTO - NOTNLM
OT  - hepatocellular carcinoma
OT  - lenvatinib
OT  - meta-analysis
OT  - sorafenib
OT  - systemic therapy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/01/10 06:00
MHDA- 2023/01/10 06:01
PMCR- 2022/01/01
CRDT- 2023/01/09 04:15
PHST- 2022/08/03 00:00 [received]
PHST- 2022/12/06 00:00 [accepted]
PHST- 2023/01/09 04:15 [entrez]
PHST- 2023/01/10 06:00 [pubmed]
PHST- 2023/01/10 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.1010726 [doi]
PST - epublish
SO  - Front Oncol. 2022 Dec 22;12:1010726. doi: 10.3389/fonc.2022.1010726. eCollection 
      2022.