PMID- 38305611
OWN - NLM
STAT- MEDLINE
DCOM- 20240205
LR  - 20240206
IS  - 2284-0729 (Electronic)
IS  - 1128-3602 (Linking)
VI  - 28
IP  - 2
DP  - 2024 Jan
TI  - Efficacy and safety of camrelizumab combined with TACE for hepatocellular 
      carcinoma: a systematic review and meta-analysis.
PG  - 687-701
LID - 35066 [pii]
LID - 10.26355/eurrev_202401_35066 [doi]
AB  - OBJECTIVE: Hepatocellular carcinoma (HCC) represents a highly lethal and 
      recurrent neoplasm, with limited effective treatment regimens available. 
      Camrelizumab, as a novel PD1 inhibitor combined with transcatheter arterial 
      chemoembolization (TACE), has been widely used in the treatment of HCC. However, 
      there remains a contentious debate regarding the clinical value of the TACE and 
      camrelizumab combination. This study seeks to investigate the efficacy and safety 
      of this combination treatment regimen in patients with HCC. MATERIALS AND 
      METHODS: The related studies were retrieved from four online databases, including 
      Pubmed, Cochrane Library, EMBASE, and Web of Science, up to June 1, 2023. The 
      selection of studies was based on screening of titles, abstracts, and full-texts. 
      The primary efficacy outcomes included complete response (CR), objective response 
      rate (ORR), and disease control rate (DCR), while safety outcomes evaluated all 
      treatment-related adverse events (AEs). Additionally, secondary outcomes such as 
      overall (OS) and progression-free survival (PFS) were extracted for further 
      survival analysis. The quality of the included trials was assessed using the 
      MINORS tool. Publication bias was evaluated through funnel plot and Egger's test. 
      RESULTS: A total of 17 publications involving 1,377 cases were included. The 
      pooled CR rate, ORR, and DCR of the patients treated with TACE plus camrelizumab 
      had a pooled CR rate of 8% (95% CI: 0.01-0.15, p=0.03), ORR of 47% (95% CI: 
      0.42-0.52, p<0.00001) and DCR of 82% (95% CI: 0.77-0.88, p<0.00001), 
      respectively. Compared with a control group that did not receive TACE or 
      camrelizumab, the pooled RR of CR rate, ORR, and DCR were 1.61 (95% CI: 
      1.27-2.04, p<0.0001), 1.56 (95% CI: 1.19-2.05, p=0.001) and 1.55 (95% CI: 
      1.19-2.03, p=0.001), respectively. Besides, the combination regimen can prolong 
      the OS (HR=2.60, 95% CI: 2.25-3.02, p<0.00001) and PFS (HR=4.90, 95% CI: 
      1.94-12.38, p=0.0008). However, the incidence of treatment-related AEs was 
      relatively high (77%), with 29% for grade 3 AEs. The most common AEs observed 
      were pain (47%), fever (46%), hepatic function abnormalities (44%), 
      hypoalbuminemia (39%), and hypertension (37%). The combination treatment did not 
      increase the incidence of AEs compared to the control group, except for the 
      hand-foot skin reaction (RR=0.85, 0.74-0.97, p=0.01), hepatic encephalopathy 
      (RR=4.29, 2.51-7.35, p<0.00001) and nausea (RR=1.35, 1.13-1.61, p=0.001). 
      CONCLUSIONS: Combination therapy of TACE plus camrelizumab has shown notable 
      clinical benefits, improved survival, and a manageable safety profile in patients 
      with HCC, but it is essential to monitor and manage the specific toxicities, 
      especially for the camrelizumab-related AEs.
FAU - Xian, F
AU  - Xian F
AD  - School of Medicine, University of Electronic Science and Technology of China, 
      Chengdu, China. xfyixue@sina.com.
FAU - Song, X-W
AU  - Song XW
FAU - Bie, J
AU  - Bie J
FAU - Zhao, C-X
AU  - Zhao CX
FAU - Zhang, G-J
AU  - Zhang GJ
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  - 73096E137E (camrelizumab)
RN  - 0 (Antibodies, Monoclonal, Humanized)
SB  - IM
MH  - Humans
MH  - *Carcinoma, Hepatocellular/drug therapy/pathology
MH  - *Liver Neoplasms/drug therapy/pathology
MH  - *Chemoembolization, Therapeutic/adverse effects
MH  - Neoplasm Recurrence, Local/therapy
MH  - Pathologic Complete Response
MH  - *Antibodies, Monoclonal, Humanized
EDAT- 2024/02/02 12:43
MHDA- 2024/02/05 06:43
CRDT- 2024/02/02 09:39
PHST- 2024/02/05 06:43 [medline]
PHST- 2024/02/02 12:43 [pubmed]
PHST- 2024/02/02 09:39 [entrez]
AID - 35066 [pii]
AID - 10.26355/eurrev_202401_35066 [doi]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2024 Jan;28(2):687-701. doi: 
      10.26355/eurrev_202401_35066.