Lenvatinib Versus Atezolizumab Plus Bevacizumab in the First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Meta-Analysis of Real-World Studies

Wang, Bi-Cheng; Kuang, Bo-Hua; Lin, Guo-He

doi:10.1007/s11523-024-01035-2

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…The clinical outcomes of atezolizumab plus bevacizumab vs. lenvatinib in patients with unresectable HCC (uHCC) were compared by meta-analyses. Atezolizumab plus bevacizumab resulted in better PFS [ 135 ], comparable OS [ 136 , 137 ] and PFS [ 137 ], or worse OS and PFS [ 136 ] compared with lenvatinib. In non-viral aHCC patients, lenvatinib was associated with signinficantly improved OS and PFS compared to atezolizumab plus bevacizumab [ 138 ], but ORR and DCR were not significantly different in the two treatment groups [ 135 – 137 ].…”

Section: Future Perspectivesmentioning

confidence: 99%

Small molecule tyrosine kinase inhibitors approved for systemic therapy of advanced hepatocellular carcinoma: recent advances and future perspectives

Liu,

Xia,

Zhang

et al. 2024

Discov Onc

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Liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer death in the world, and hepatocellular carcinoma (HCC) is the most common form of liver cancer. More than half of the HCC patients are diagnosed at an advanced stage and often require systemic therapy. Dysregulation of the activity of receptor tyrosine kinases (RTKs) is involved in the development and progress of HCC, RTKs are therefore the potential targets for systemic therapy of advanced HCC (aHCC). Currently, a total of six small molecule tyrosine kinase inhibitors (TKIs) have been approved for aHCC, including first-line sorafenib, lenvatinib, and donafenib, and second-line regorafenib, cabozantinib, and apatinib. These TKIs improved patients survival, which are associated with disease stage, etiology, liver function, tumor burden, baseline levels of alpha-fetoprotein, and treatment history. This review focuses on the clinical outcomes of these TKIs in key clinical trials, retrospective and real-world studies and discusses the future perspectives of TKIs for aHCC, with an aim to provide up-to-date evidence for decision-making in the treatment of aHCC.

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Section: Future Perspectivesmentioning

confidence: 99%

Small molecule tyrosine kinase inhibitors approved for systemic therapy of advanced hepatocellular carcinoma: recent advances and future perspectives

Liu,

Xia,

Zhang

et al. 2024

Discov Onc

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Recent developments in molecular targeted therapies for hepatocellular carcinoma in the genomic era

Testa

2024

Expert Review of Molecular Diagnostics

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Effect of Subgroups on Study Outcomes in Unresectable Hepatocellular Carcinoma Undergoing Upfront Systemic Treatment

Colloca,

Venturino

2024

American Journal of Clinical Oncology

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Objectives: Immunotherapy improved the outcome of patients with unresectable hepatocellular carcinoma, but not all studies are in agreement, nor is it clear whether certain subgroups have really benefited. This study aims to perform an updated meta-analysis of trials comparing upfront immunotherapy-based regimens versus tyrosin-kinase inhibitors, and some exploratory analyses. Methods: After a systematic review, randomized trials of immunotherapy-based regimens versus tyrosin-kinase inhibitors were selected. A meta-analysis assessed the relationship between treatment arm and overall survival. Based on the resulting heterogeneity, a further investigation of 11 variables by meta-regression and an exploration of subgroups were planned. Results: Eight studies were selected. From the meta-analysis, the overall survival improvement for the immunotherapy-based arms was consistent (HR: 0.77, CI: 0.68-0.88), although heterogeneity between studies was significant (Q=16.37; P=0.0373; I 2=51.1%). After meta-regression, the effect of the experimental arm was more pronounced in the elderly and lost among patients with HCV-related liver disease. Subgroups suggested a favorable effect of immunotherapy in patients with HBV-related hepatocellular carcinoma, extrahepatic dissemination, and elevated alpha-fetoprotein. Conclusion: The study results confirm the significant overall survival improvement after immunotherapy-based regimens but suggest different effects on the outcome depending on age, etiology of liver disease, and tumor burden.

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Lenvatinib Versus Atezolizumab Plus Bevacizumab in the First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Meta-Analysis of Real-World Studies

Cited by 3 publications

References 27 publications

Small molecule tyrosine kinase inhibitors approved for systemic therapy of advanced hepatocellular carcinoma: recent advances and future perspectives

Small molecule tyrosine kinase inhibitors approved for systemic therapy of advanced hepatocellular carcinoma: recent advances and future perspectives

Recent developments in molecular targeted therapies for hepatocellular carcinoma in the genomic era

Effect of Subgroups on Study Outcomes in Unresectable Hepatocellular Carcinoma Undergoing Upfront Systemic Treatment

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