PMID- 36910612
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230710
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 13
DP  - 2023
TI  - Transarterial chemoembolization combined with lenvatinib versus transarterial 
      chemoembolization combined with sorafenib for unresectable hepatocellular 
      carcinoma: A systematic review and meta-analysis.
PG  - 1074793
LID - 10.3389/fonc.2023.1074793 [doi]
LID - 1074793
AB  - BACKGROUND: The combination of tyrosine kinase inhibitors (TKIs) and 
      transarterial chemoembolization (TACE) fulfills an important role in the 
      treatment of unresectable hepatocellular carcinoma (uHCC). Among the combination 
      therapies, both lenvatinib and sorafenib combined with TACE are recommended as 
      first- notline treatments for uHCC. However, at present, limited data are available 
      concerning the efficacy and safety of these two combination therapies in uHCC. 
      METHODS: A detailed systematic search for studies on lenvatinib plus TACE 
      (LEN+TACE) and sorafenib plus TACE (SOR+TACE) was conducted in the online 
      databases PubMed, Embase and The Cochrane Library. The outcome data including 
      overall survival (OS), progression free survival (PFS), time to progression 
      (TTP), tumor response and adverse events (AEs), were independently extracted by 
      two authors in a standardized way. RESULTS: One randomized controlled trial and 
      five cohort studies with 598 patients (LEN+TACE: 261, SOR+TACE: 337) were 
      included in the meta-analysis. A higher rate of odds ratio (OR) for the objective 
      response rate (ORR) [OR: 3.63; 95% confidence intervals (95% CI): 1.89-6.95; I 
      squared statistic (I2) = 57%, P < 0.001] and disease control rate (DCR) (OR: 
      3.78; 95% CI: 2.00-7.16; I2 = 52%, P = 0.0001) were observed in the LEN+SOR group 
      compared with the SOR+TACE group. The LEN+TACE group also had significant longer 
      OS [hazard ratio (HR): 0.67; 95% CI: 0.52-0.85; I2 = 1%, P = 0.001], PFS (HR: 
      0.49; 95% CI: 0.38-0.62; I2 = 0%, P? 0.001) and TTP (HR: 0.62; 95% CI: 0.45-0.84; 
      I2 = 0%, P = 0.002) compared with the SOR+TACE group. The incidence of 
      hypertension (OR: 3.05; 95% CI: 1.45-6.39; P = 0.003) and proteinuria (OR: 5.25; 
      95% CI: 1.73-15.89; P = 0.003) were significantly higher in the LEN+TACE group 
      than SOR+TACE group, while LEN+TACE group exhibited a lower rate of 
      hand-foot-skin reaction (HFSR) (OR: 0.51; 95% CI: 0.27-0.95; P = 0.03) compared 
      with the SOR+TACE group. CONCLUSION: The combination therapy of LEN+TACE showed 
      significant superiority compared with SOR+TACE in terms of its efficacy for 
      patients with uHCC. SOR+TACE should be recommended as a replacement therapy when 
      serious AEs occur during the administration of LEN+TACE as the combination 
      therapy.
CI  - Copyright (c) 2023 Liu, Li, Yan, Zhang and Yi.
FAU - Liu, Jun-Ning
AU  - Liu JN
AD  - Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, China.
FAU - Li, Ji-Jiang
AU  - Li JJ
AD  - Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, China.
FAU - Yan, Shu
AU  - Yan S
AD  - Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, China.
FAU - Zhang, Guang-Nian
AU  - Zhang GN
AD  - Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, China.
FAU - Yi, Peng-Sheng
AU  - Yi PS
AD  - Department of Hepato-Biliary-Pancreas II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, China.
LA  - eng
PT  - Systematic Review
DEP - 20230223
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
EIN - Front Oncol. 2023 Jun 22;13:1233247. PMID: 37427117
PMC - PMC9995877
OTO - NOTNLM
OT  - combination therapy
OT  - hepatocellular carcinoma (HCC)
OT  - lenvatinib
OT  - sorafenib (nexavar)
OT  - transarterial chemoembolization (TACE)
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- 2023/03/14 06:00
MHDA- 2023/03/14 06:01
PMCR- 2023/01/01
CRDT- 2023/03/13 04:15
PHST- 2022/10/20 00:00 [received]
PHST- 2023/01/31 00:00 [accepted]
PHST- 2023/03/13 04:15 [entrez]
PHST- 2023/03/14 06:00 [pubmed]
PHST- 2023/03/14 06:01 [medline]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2023.1074793 [doi]
PST - epublish
SO  - Front Oncol. 2023 Feb 23;13:1074793. doi: 10.3389/fonc.2023.1074793. eCollection 
      2023.