Trans-catheter arterial chemoembolization plus Sorafenib, an unsuccessful therapy in the treatment of hepatocellular carcinoma?

Abstract

Background: Trans-catheter arterial chemoembolization (TACE) plus Sorafenib is recommended as one of the primary means for treating hepatocellular carcinoma (HCC). This updated meta-analysis focuses on identifying the efficacy and safety of TACE plus Sorafenib versus TACE, which remains controversial despite years of exploration. Method: PubMed, Medline, Embase, China Journal Full-text Database, Wanfang Database, and Weipu Database were used to retrieve the studies which are about comparing the clinical efficacy and safety of TACE+Sorafenib with TACE alone. The Review Manager (Version 5. 3) software was used to perform a meta-analysis of the results of studies which met the inclusion criteria recommended by the Cochrane Collaboration. Result: Compared with TACE for treating primary HCC, TACE combined with Sorafenib can improve the 1 year, 2 years, 3 years, and 5 years overall survival rate (OS) of patients, respectively, and also improve disease control rate (DCR) and objective response rate (ORR). In terms of adverse reactions, the treatment group can lead to more complications significantly, such as hand-foot skin reaction, hypertension, diarrhea, rash, hair loss, and so on, most of which are relevant to Sorafenib related adverse reactions, but most patients have a good prognosis after symptomatic treatment. Conclusion: The clinical efficacy of TACE combined with Sorafenib in treating primary hepatocellular carcinoma is better than TACE, and the safety is acceptable.

Optimal timing of combining sorafenib with trans-arterial chemoembolization in patients with hepatocellular carcinoma: A meta-analysis

“…Zhang et al. [24] analyzed 15 studies including 5 RCTs and 10 NRCTs in a total of 3104 patients with primary HCC and pointed that TACE + sorafenib can prolong the 1-year, 2-year, 3-year, and 5-year OS of patients, respectively, and improve ORR and DCR. Jin et al.…”

“…However, as for AEs, a previous meta-analysis showed that TACE + sorafenib can lead to more complications significantly [ 22 – 24 ]. Our meta-analysis is consistent with the results of previous studies, in which the HFSR and diarrhea, fatigue, hypertension, nausea, and rash/desquamation were common in the combination group.…”

Efficacy of Transarterial Chemoembolization Combined with Molecular Targeted Agents for Unresectable Hepatocellular Carcinoma: A Network Meta-Analysis

“…However, when used alone, the TKIs may have limited efficacy due to the emergence of resistance and side effects. Hence, TACE combined with different TKIs has been widely used recently for uHCC [ 7 , 8 , 9 ]. On the one hand, TACE can enhance or improve the efficacy and tolerability of TKIs when combined with TKIs.…”

“…Three clinical randomized controlled trials (RCTs) (i.e., post-TACE, SPACE, and TACE-2) had unsatisfactory results and failed to demonstrate the clinical benefit of combination therapy over TACE alone [ 11 , 18 , 19 ]. Several recent systematic reviews and meta-analyses have reported that SOR-TACE was better and safer in treating HCC than TACE alone [ 8 , 9 , 18 ]. Secondly, two meta-analysis [ 7 , 19 ] demonstrated that apatinib combined with TACE provides better survival benefits for advanced-stage HCC patients than TACE monotherapy.…”

Clinical Effect of Iodine-125 Seed Implantation in Patients with Primary Liver Cancer and Its Effect on Th1/Th2 Cells in Peripheral Blood

“…Chemotherapy is the preferred treatment for patients with primary liver cancer; transarterial chemoembolization (TACE) is the main treatment [ 17 , 18 ]. High concentration of chemotherapeutic drugs can be injected into the tumor lesions, and then the tumor supplying blood vessels can be embolized through an embolization agent, which can make the tumor inactivated under the dual effects of ischemia and hypoxia.…”