Quantitative evaluation of the efficacy and safety of first-line systemic therapies for advanced hepatocellular carcinoma.

Objectives: This study aimed to quantitatively evaluate the efficacy and safety of first-line systemic therapies for treating advanced hepatocellular carcinoma (aHCC). Methods: The study included clinical trials of first-line systemic therapies for aHCC since the approval of sorafenib in 2007. Hazar...

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Publicado en:European Journal of Clinical Pharmacology Vol. 81; no. 3; pp. 383 - 394
Autores principales: Wang, Xinrui, Huang, Jihan, Liu, Yixiao, Wu, Lijuan, Cai, Ruifen, Zheng, Qingshan, Li, Lujin
Formato: research tables/charts Journal Article
Publicado: Springer Nature Mar2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2025
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-024-03797-0
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        atl: Quantitative evaluation of the efficacy and safety of first-line systemic therapies for advanced hepatocellular carcinoma.
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          Wang, Xinrui
          Huang, Jihan
          Liu, Yixiao
          Wu, Lijuan
          Cai, Ruifen
          Zheng, Qingshan
          Li, Lujin
        affil: https://ror.org/00z27jk27 Center for Pharmacometrics, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, No.1200 Cailun Road, 201203, Shanghai, China
      sug:
        subj:
          Carcinoma, Hepatocellular Drug Therapy
          Carcinoma, Hepatocellular Prognosis
          Antineoplastic Agents Therapeutic Use
          Drug Efficacy Evaluation
          Patient Safety Evaluation
          Overall Survival
          Progression-Free Survival
          Human
          Funding Source
          Male
          Female
          Middle Age
          Aged
          Quantitative Studies
          Immune Checkpoint Inhibitors
          Sorafenib
          Drug Approval
          Antineoplastic Agents, Combined
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objectives: This study aimed to quantitatively evaluate the efficacy and safety of first-line systemic therapies for treating advanced hepatocellular carcinoma (aHCC). Methods: The study included clinical trials of first-line systemic therapies for aHCC since the approval of sorafenib in 2007. Hazard function models were used to describe changes in overall survival (OS) and progression-free survival (PFS) over time. Monte Carlo simulation was used to compare OS and PFS for different treatments, including sorafenib, antiangiogenic therapies (AATs) (except sorafenib), immune checkpoint inhibitor (ICI) monotherapy, AAT + targeted therapy, AAT + chemotherapy, AAT + ICIs, and ICIs + ICIs. Furthermore, the objective response rate (ORR) and incidence of grade ≥ 3 adverse events were analyzed. Results: Fifty studies comprising 12,918 participants were included. AAT + ICIs demonstrated a significant benefit in median OS (mOS), median PFS (mPFS), and ORR (20.5 [95% CI 17.5–24] months, 7.5 [95% CI 6.5–8.8] months, and 24% [95% CI 17%–30%], respectively). ICIs + ICIs and ICI monotherapy ranked second and third, respectively with an mOS of 20 (95% CI 18.5–21.5) months and 14.5 (95% CI 13.5–16) months, respectively. The OS, PFS, and ORR of patients treated with AAT, AAT + targeted therapy, and AAT + chemotherapy were similar to those of patients treated with sorafenib. A higher proportion of patients with Barcelona Clinic Liver Cancer (BCLC) stage C had a shorter OS. OS was associated with publication year, and PFS was associated with the proportion of patients with BCLC stage C. The incidence of grade ≥ 3 adverse events in the ICIs and ICIs + ICIs treatment groups was low. Conclusions: The study results provide valuable information from which to base rational clinical drug use and serves as a reliable external control for evaluating new treatments for aHCC.
      pubtype: Academic Journal
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        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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