PMID- 38369433
OWN - NLM
STAT- Publisher
LR  - 20240218
IS  - 1477-2574 (Electronic)
IS  - 1365-182X (Linking)
DP  - 2024 Feb 9
TI  - Comparison of tumor response and outcomes of patients with hepatocellular 
      carcinoma after multimodal treatment including immune checkpoint inhibitors - a 
      systematic review and meta-analysis.
LID - S1365-182X(24)00022-4 [pii]
LID - 10.1016/j.hpb.2024.02.003 [doi]
AB  - BACKGROUND: The efficacy of immune checkpoint inhibitors (ICIs) combined with 
      tyrosine kinase inhibitors (TKIs), trans-arterial chemoembolization (TACE), and 
      radiotherapy to treat hepatocellular carcinoma (HCC) has not been well-defined. 
      We performed a meta-analysis to characterize tumor response and survival 
      associated with multimodal treatment of HCC. METHODS: PubMed, Embase, Medline, 
      Scopus, and CINAHL databases were searched (1990-2022). Random-effect 
      meta-analysis was conducted to compare efficacy of treatment modalities. Odds 
      ratios (OR) and standardized mean difference (SMD) were reported. RESULTS: Thirty 
      studies (4170 patients) met inclusion criteria. Triple therapy regimen 
      (ICI + TKI + TACE) had the highest overall disease control rate (DCR) (87%, 95% 
      CI 83-91), while ICI + radiotherapy had the highest objective response rate (ORR) 
      (72%, 95% CI 54%-89%). Triple therapy had a higher DCR than ICI + TACE (OR 4.49, 
      95% CI 2.09-9.63), ICI + TKI (OR 3.08, 95% CI 1.63-5.82), and TKI + TACE (OR 
      2.90, 95% CI 1.61-5.20). Triple therapy demonstrated improved overall survival 
      versus ICI + TKI (SMD 0.72, 95% CI 0.37-1.07) and TKI + TACE (SMD 1.13, 95% CI 
      0.70-1.48) (both p < 0.05). Triple therapy had a greater incidence of adverse 
      events (AEs) compared with ICI + TKI (OR 0.59, 95% CI 0.29-0.91; p = 0.02), but 
      no difference in AEs versus ICI + TACE or TKI + TACE (both p > 0.05). CONCLUSION: 
      The combination of ICIs, TKIs and TACE demonstrated superior tumor response and 
      survival and should be considered for select patients with advanced HCC.
CI  - Copyright (c) 2024 International Hepato-Pancreato-Biliary Association Inc. 
      Published by Elsevier Ltd. All rights reserved.
FAU - Dawood, Zaiba S
AU  - Dawood ZS
AD  - Medical College, The Aga Khan University Hospital, Stadium Road, Karachi, 74800, 
      Pakistan.
FAU - Brown, Zachary J
AU  - Brown ZJ
AD  - Department of Surgery, New York University Long Island School of Medicine, 
      Mineola, NY, USA.
FAU - Alaimo, Laura
AU  - Alaimo L
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Lima, Henrique A
AU  - Lima HA
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Shaikh, Chanza
AU  - Shaikh C
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Katayama, Erryk S
AU  - Katayama ES
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Munir, Muhammad M
AU  - Munir MM
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Moazzam, Zorays
AU  - Moazzam Z
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Endo, Yutaka
AU  - Endo Y
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Woldesenbet, Selamawit
AU  - Woldesenbet S
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA.
FAU - Pawlik, Timothy M
AU  - Pawlik TM
AD  - Department of Surgery, The Ohio State University Wexner Medical Center and James 
      Comprehensive Cancer Center, Columbus, OH, USA. Electronic address: 
      Tim.Pawlik@osumc.edu.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240209
PL  - England
TA  - HPB (Oxford)
JT  - HPB : the official journal of the International Hepato Pancreato Biliary 
      Association
JID - 100900921
SB  - IM
EDAT- 2024/02/19 00:43
MHDA- 2024/02/19 00:43
CRDT- 2024/02/18 21:54
PHST- 2023/07/20 00:00 [received]
PHST- 2024/01/13 00:00 [revised]
PHST- 2024/02/06 00:00 [accepted]
PHST- 2024/02/19 00:43 [medline]
PHST- 2024/02/19 00:43 [pubmed]
PHST- 2024/02/18 21:54 [entrez]
AID - S1365-182X(24)00022-4 [pii]
AID - 10.1016/j.hpb.2024.02.003 [doi]
PST - aheadofprint
SO  - HPB (Oxford). 2024 Feb 9:S1365-182X(24)00022-4. doi: 10.1016/j.hpb.2024.02.003.