PMID- 37658861
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20231102
IS  - 1432-1335 (Electronic)
IS  - 0171-5216 (Linking)
VI  - 149
IP  - 17
DP  - 2023 Nov
TI  - Efficacy and safety of atezolizumab plus bevacizumab versus lenvatinib for 
      unresectable hepatocellular carcinoma: a systematic review and meta-analysis.
PG  - 16191-16201
LID - 10.1007/s00432-023-05342-5 [doi]
AB  - BACKGROUND: Atezolizumab plus bevacizumab and lenvatinib are the current 
      first-line systematic therapy for unresectable hepatocellular carcinoma (uHCC). 
      However, the selection of initial treatment among the two therapies are 
      controversial. This meta-analysis aims to compare efficacy and safety between 
      atezolizumab plus bevacizumab and lenvatinib. METHODS: We systematically searched 
      for studies on atezolizumab plus bevacizumab and lenvatinib in the online 
      databases PubMed, Embase, Web of Science and Cochrane Library. The outcome data 
      including overall survival (OS), progression free survival (PFS), tumor response 
      and adverse events (AEs), were independently extracted by two authors in a 
      standardized way. RESULTS: Eight retrospective cohort studies with 3690 patients 
      (atezolizumab plus bevacizumab: 1680, lenvatinib: 2010) were included in the 
      meta-analysis. The atezolizumab plus bevacizumab group had significant longer PFS 
      [hazard ratio (HR) 0.76, 95% confidence intervals (CI) 0.65-0.88; I squared 
      statistic (I(2)) = 0.0%, p = 0.590], compared with lenvatinib group but no 
      significant difference in OS (HR 0.87, 95% CI 0.75-1.01; I(2) = 0.0%, p = 0.597), 
      objective response rate (ORR) [risk ratio (RR) 0.89, 95% CI 0.79-1.02; 
      I(2) = 19.3%, p = 0.283] and disease control rate (DCR) (RR 1.03, 95% CI 
      0.98-1.09; I(2) = 0.0%, p = 0.467) among them. Moreover, patients receiving 
      atezolizumab plus bevacizumab exhibited lower incidences of grade 3/4 AEs than 
      those receiving lenvatinib (RR 0.65, 95% CI 0.51-0.83; I(2) = 69.3%, p = 0.003). 
      However, in non-viral patients group, lenvatinib delivered favorable outcomes in 
      OS (HR 1.32, 95% CI 1.04-1.67; I(2) = 0.0%, p = 0.380) compared with atezolizumab 
      plus bevacizumab. CONCLUSION: Atezolizumab plus bevacizumab provides potential 
      advantage in efficacy and better safety than lenvatinib in the treatment of uHCC. 
      Lenvatinib is an appropriate effective alternative to atezolizumab plus 
      bevacizumab in patients without viral infecting.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Liu, Junning
AU  - Liu J
AD  - Department of Hepato-Biliary-Pancrease II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, 637000, China.
FAU - Yang, Linfeng
AU  - Yang L
AD  - Department of Hepato-Biliary-Pancrease II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, 637000, China.
FAU - Wei, Song
AU  - Wei S
AD  - Department of Hepato-Biliary-Pancrease II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, 637000, China.
FAU - Li, Jijiang
AU  - Li J
AD  - Department of Hepato-Biliary-Pancrease II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, 637000, China.
FAU - Yi, Pengsheng
AU  - Yi P
AD  - Department of Hepato-Biliary-Pancrease II, Affiliated Hospital of North Sichuan 
      Medical College, Nanchong, 637000, China. liujunning98@163.com.
LA  - eng
GR  - 22SXQT0052/Bureau of Science and Technology Nanchong City/
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230902
PL  - Germany
TA  - J Cancer Res Clin Oncol
JT  - Journal of cancer research and clinical oncology
JID - 7902060
RN  - 52CMI0WC3Y (atezolizumab)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - EE083865G2 (lenvatinib)
SB  - IM
MH  - Humans
MH  - Bevacizumab/adverse effects
MH  - *Carcinoma, Hepatocellular/drug therapy
MH  - Retrospective Studies
MH  - *Liver Neoplasms/drug therapy
OTO - NOTNLM
OT  - Atezolizumab
OT  - Bevacizumab
OT  - Hepatocellular carcinoma
OT  - Lenvatinib
OT  - Meta-analysis
EDAT- 2023/09/04 01:22
MHDA- 2023/11/02 12:42
CRDT- 2023/09/02 11:03
PHST- 2023/07/30 00:00 [received]
PHST- 2023/08/24 00:00 [accepted]
PHST- 2023/11/02 12:42 [medline]
PHST- 2023/09/04 01:22 [pubmed]
PHST- 2023/09/02 11:03 [entrez]
AID - 10.1007/s00432-023-05342-5 [pii]
AID - 10.1007/s00432-023-05342-5 [doi]
PST - ppublish
SO  - J Cancer Res Clin Oncol. 2023 Nov;149(17):16191-16201. doi: 
      10.1007/s00432-023-05342-5. Epub 2023 Sep 2.