First-Line Systemic Treatment Strategies for Unresectable Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials.
First-Line Systemic Treatment Strategies for Unresectable Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials.
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DOI：
10.3389/fonc.2021.771045
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发表时间：
2021
影响因子：
4.7
通讯作者：
Yin X
中科院分区：
文献类型：
--
作者：
Liu W;Quan B;Lu S;Tang B;Li M;Chen R;Ren Z;Yin X
最近批准了几种新的一线治疗方法用于治疗不可切除的肝细胞癌（HCC）。在这项荟萃分析中，我们比较了一线系统治疗的有效性和安全性，为不可切除的 HCC 的临床决策提供信息。检索了 Pubmed、Science Direct、Web of Science、Scopus、Ovid MEDLINE、Embase、Google Scholar、Cochrane Library、EMbase、CNKI、CBM、VIP、万方数据库以及 Cochrane 对照试验中心注册库，评价一线化疗、分子靶向治疗或免疫治疗对不可切除性 HCC 疗效的随机临床试验。计算 95% 置信区间 (CI) 的风险比，以探讨各种治疗方案对总生存 (OS) 和无进展生存 (PFS) 的影响，而 95% CI 的奇数比用于不良事件 (AE) 和严重不良事件 (SAE)。进行网络荟萃分析来综合数据并在治疗之间进行直接和间接比较。累积排名曲线（SUCRA）和P评分用于对治疗进行排名。使用漏斗图和 Egger 回归测试以图形和数字方式评估跨研究的偏倚风险。分析了 15 项研究，包括 9005 名患者。信迪利单抗联合贝伐单抗、阿替利珠单抗联合贝伐单抗和多纳非尼的 OS 结局优于索拉非尼。信迪利单抗联合贝伐单抗、阿特珠单抗联合贝伐单抗、乐伐替尼和利尼尼布的 PFS 结局优于索拉非尼。网络荟萃分析结果显示，信迪利单抗联合贝伐珠单抗与最佳 OS 和 PFS 相关。 Egger 的测试表明，纳入的研究均未出现明显的发表偏差。信迪利单抗联合贝伐珠单抗显示出最佳的 OS 和 PFS 结果，没有额外的 AE 或 SAE。因此，信迪利单抗联合贝伐珠单抗可能是治疗不可切除的 HCC 患者更好的一线选择。普洛斯彼罗 []，标识符 CRD42021269734。
Several new first-line treatments were recently approved for unresectable hepatocellular carcinoma (HCC). In this meta-analysis, we compare the efficacy and safety of first-line systemic treatments to provide information for clinical decision making in unresectable HCC. Pubmed, Science Direct, Web of Science, Scopus, Ovid MEDLINE, Embase, Google Scholar, the Cochrane Library, EMbase, CNKI, CBM, VIP, and the Wanfang databases, as well as the Cochrane Central Register of Controlled Trails were searched for randomized clinical trials evaluating the efficacy of first-line chemotherapy, molecular targeted therapy, or immunotherapy for unresectable HCC. Hazard ratios with 95% confidence intervals (CIs) were calculated to explore the effects of various treatment options on overall survival (OS) and progression-free survival (PFS), whereas odd ratios with 95% CIs were used for adverse events (AEs) and serious adverse events (SAEs). A network meta-analysis was performed to synthesize data and for direct and indirect comparisons between treatments. The cumulative ranking curve (SUCRA) and P score were used to rank treatments. The risk of bias across studies was assessed graphically and numerically using the funnel plot and Egger’s regression test. Fifteen studies including 9005 patients were analyzed. Sintilimab plus bevacizumab, atezolizumab plus bevacizumab, and donafenib had better OS outcomes than sorafenib. Sintilimab plus bevacizumab, atezolizumab plus bevacizumab, lenvatinib, and linifanib had better PFS outcomes than sorafenib. The results of network meta-analysis showed that sintilimab plus bevacizumab was associated with the best OS and PFS. Egger’s tests indicated that none of the included studies had obvious publication deviation. Sintilimab plus bevacizumab showed the best OS and PFS outcomes with no additional AEs or SAEs. Thus, sintilimab plus bevacizumab may be a better first line choice for the treatment of patients with unresectable HCC. PROSPEROI [], identifier CRD42021269734.
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影响因子：
11.5
作者：
Hoy, Sheridan M.
通讯作者：
Hoy, Sheridan M.
影响因子：
13.5
作者：
Calderaro, Julien;Rousseau, Benoit;Pawlotsky, Jean-Michel
通讯作者：
Pawlotsky, Jean-Michel
影响因子：
158.5
作者：
Finn, Richard S.;Qin, Shukui;Cheng, Ann-Lii
通讯作者：
Cheng, Ann-Lii
影响因子：
168.9
作者：
Bruix, Jordi;Qin, Shukui;Han, Guohong
通讯作者：
Han, Guohong
索拉非尼对亚太地区晚期肝细胞癌患者的疗效和安全性：一项 III 期随机、双盲、安慰剂对照试验
影响因子：
51.1
作者：
Cheng, Ann-Lii;Kang, Yoon-Koo;Guan, Zhongzhen
通讯作者：
Guan, Zhongzhen