Thalidomide combined with transcatheter artierial chemoembolzation for primary hepatocellular carcinoma: a systematic review and meta-analysis

Abstract

ObjectiveTranscatheter arterial chemoembolization (TACE) and thalidomide have been used for treating primary hepatocellular carcinoma(HCC). This study aims to evaluate the clinical efficacy and safety of thalidomide and TACE in primary HCC.MethodsRandomized controlled trials(RCTs) about efficacy and safety of thalidomide combined with TACE for primary HCC were identified from the Cochrane Library, Pubmed, Embase, CNKI, and Wan Fang until August, 2016. The retrieved trials were reviewed and the data were extracted by two reviewers, independently. Combined analyses of survival rates, overall response rate(ORR), disease control rate(DCR), changes of KPS, parameters of cellular immunity and vascular endothelial growth factor(VEGF), and adverse events were performed using RevMan 5.3 software.ResultsA total of 23 RCTs involving 1836 patients were included. The results showed that thalidomide plus TACE was significantly superior in increasing 6-month survival rate(OR=1.79, 95% CI:1.02-3.15, P=0.04), 1-year survival rate(OR=1.76, 95% CI:1.38-2.24, P<0.0001), 1.5-year survival rate(OR=4.72, 95% CI:2.64-8.43, P<0.001), 2-year survival rate(OR=1.78, 95% CI:1.37-2.30, P<0.001), ORR(OR=1.89, 95% CI:1.48-2.42, P<0.0001), DCR(OR=2.62, 95% CI:1.90-3.63, P<0.001), improvement in cellular immunity(MD=0.63, 95% CI:0.45-0.80, P<0.0001), and reduction of VEGF(MD=-119.71, 95% CI:-135.75—103.68, P<0.0001), when compared with TACE group. The incidences of gastrointestinal reactions, myelosuppression, and liver dysfunction were similar between combination group and TACE group(P>0.05). However, compared to TACE, the combination of thalidomide and TACE had a higher incidence of drug rash(OR=6.35, 95% CI:2.75-14.68, P<0.0001).ConclusionOur findings suggest that thalidomide combined with TACE shows better clinical efficacy and tolerable adverse events in patients with primary HCC when compared with TACE alone.

Efficacy and Safety of Thalidomide for Chemotherapy-induced Nausea and Vomiting

“…THD, as an antiangiogenic agent, has produced substantial clinical benefits in the treatment of multiple myeloma, and its effects on a host of solid tumors have been quite variable. There seems to be a reasonable consensus that THD has demonstrable tumoristatic effects in renal cell carcinoma [49], hepatocellular carcinoma [50,51], prostate carcinoma [52], Kaposi's sarcoma [53], melanoma [54], glioma [55], and glioblastoma multiforme [56]. The main pathophysiological features of advanced cancer are insomnia, chronic emesis, nausea, cachexia, metabolic disorders, and tumor-associated pain as well as decreased sensation of wellbeing.…”

Identification of Four Key Biomarkers and Small Molecule Drugs Innasopharyngeal Carcinoma by Weighted Gene Co-expression Network Analysis

“…Thalidomide, is a glutamic acid derivative, which was a classic drug with immunemodulatory properties and tumor necrosis factor alpha inhibits [50][51][52]. Subsequent studies found that thalidomide has anti-angiogenic, anti-in ammatory, anti-brotic and immune-modulatory effects, and the clinical effectiveness of thalidomide has been con rmed in the treatment of certain disease such as refractory Crohn's disease, lung metastasis, multiple myeloma, hepatocellular carcinoma, and breast carcinoma [53][54][55][56][57][58][59][60]. Our results based on the CMAP database may provide several potential smallmolecule drugs as to future therapy for NPC; nevertheless, studies in vivo and in vitro experiments are necessary.…”

Conversion to resectability using transcatheter arterial chemoembolization alternating with mFOLFOX6 in patients with colorectal liver metastases

“…[29] Furthermore, Cao's findings suggest that thalidomide combined with TACE shows better clinical efficacy and tolerable adverse events in patients with primary HCC when compared with TACE alone. [30] Li et al . presented that it is safe and effective to use TACE combined with microwave ablation in the treatment of advanced HCC, and the effect of combined treatment is better than that of TACE alone.…”