PMID- 36876689
OWN - NLM
STAT- MEDLINE
DCOM- 20230309
LR  - 20230503
IS  - 2284-0729 (Electronic)
IS  - 1128-3602 (Linking)
VI  - 27
IP  - 4
DP  - 2023 Feb
TI  - Efficacy and safety of PD1/PDL1 inhibitors combined with radiotherapy and 
      antiangiogenic drugs for hepatocellular carcinoma: a systematic review and 
      meta-analysis.
PG  - 1494-1502
LID - 31390 [pii]
LID - 10.26355/eurrev_202302_31390 [doi]
AB  - OBJECTIVE: The triplet regimen based on the programmed cell death 1 (PD1)/ 
      programmed cell death ligand 1 (PDL1) inhibitors combined radiotherapy and 
      antiangiogenic drugs is a novel therapeutic strategy for hepatocellular 
      carcinoma. We conducted a meta-analysis to evaluate the efficacy and safety of 
      the triplet therapeutic regimen in the treatment of hepatocellular carcinoma. 
      MATERIALS AND METHODS: We searched scientific literature databases and clinical 
      trial databases through October 31, 2022, for required studies. The pooled hazard 
      ratio (HR) was used to analyze the overall survival (OS), progression-free 
      survival (PFS), and the pooled relative risk (RR) was used to analyze the 
      objective response rate (ORR), disease control rate (DCR), mortality rate (MR), 
      and adverse events (AEs) through random or fixed effects model, 95% confidence 
      interval (CI) was determined for all outcomes. Qualities of the included 
      literature were assessed by MINORS Critical appraisal checklist. Funnel plot was 
      used to assess publication bias in the included studies. RESULTS: Five studies (3 
      single-arm and 2 non-randomized comparative trials), including 358 cases, were 
      enrolled. Meta-analysis showed that the pooled ORR, DCR, and MR were 51% (95% CI: 
      34%-68%), 86% (95% CI: 69-102%), and 38% (95% CI: 18-59%), respectively. Compared 
      with triplet regimen, the single or dual-combination treatments had shorter OS 
      (HR=0.53, 95%: 0.34-0.83 via univariate analysis; HR=0.49, 95%: 0.31-0.78 via 
      multivariable analysis) and PFS (HR=0.52, 95%: 0.35-0.77 via univariate analysis; 
      HR=0.54, 95%: 0.36-0.80 via multivariable analysis). Common AEs to triplet 
      regimens included skin reaction (17%), nausea/vomiting (27%), fatigue (23%), 
      while severe AEs (10%), fever (18%), diarrhea (15%), and hypertension (5%) 
      without statistically significant differences. CONCLUSIONS: In the treatment of 
      hepatocellular carcinoma, PD1/PDL1 inhibitors combined radiotherapy and 
      antiangiogenic drugs achieved better survival benefits than alone or 
      dual-combination regimens. In addition, the triple-combination therapy has 
      tolerable safety.
FAU - Xian, F
AU  - Xian F
AD  - Department of Oncology, Nanchong Central Hospital, The Second Clinical Medical 
      College, North Sichuan Medical College, Nanchong, China. 807988778@qq.com.
FAU - Wu, J
AU  - Wu J
FAU - Yuan, Y-L
AU  - Yuan YL
FAU - Bie, J
AU  - Bie J
FAU - Xu, G-H
AU  - Xu GH
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - Italy
TA  - Eur Rev Med Pharmacol Sci
JT  - European review for medical and pharmacological sciences
JID - 9717360
RN  - 0 (Angiogenesis Inhibitors)
SB  - IM
MH  - Humans
MH  - *Angiogenesis Inhibitors/therapeutic use
MH  - *Carcinoma, Hepatocellular/drug therapy/radiotherapy
MH  - Checklist
MH  - *Liver Neoplasms/drug therapy/radiotherapy
EDAT- 2023/03/07 06:00
MHDA- 2023/03/08 06:00
CRDT- 2023/03/06 06:33
PHST- 2023/03/06 06:33 [entrez]
PHST- 2023/03/07 06:00 [pubmed]
PHST- 2023/03/08 06:00 [medline]
AID - 31390 [pii]
AID - 10.26355/eurrev_202302_31390 [doi]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2023 Feb;27(4):1494-1502. doi: 
      10.26355/eurrev_202302_31390.