Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2024; 16(1): 91-102
Published online Jan 27, 2024. doi: 10.4254/wjh.v16.i1.91
Sorafenib plus transarterial chemoembolization vs sorafenib alone for patients with advanced hepatocellular carcinoma: A systematic review and meta-analysis
Hong-Jie Yang, Bin Ye, Jia-Xu Liao, Lei Lei, Kai Chen
Hong-Jie Yang, Jia-Xu Liao, Department of Radiology, The Sixth People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
Bin Ye, Lei Lei, Department of Oncology, The Sixth People's Hospital of Chengdu, Chengdu 610000, Sichuan Province, China
Kai Chen, Department of Pharmacy, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu Province, China
Co-first authors: Hong-Jie Yang and Bin Ye.
Author contributions: Yang HJ and Ye B were responsible for data acquisition, analysis, and interpretation and drafted the article; Liao JX and Lei L were responsible for data analysis and interpretation and revised the article; Chen K was responsible for conception and design of the study and critical revision of the article; all authors issued final approval for the version to be submitted. Yang HJ and Ye B contributed equally to this work as co-first authors. The reasons for designating Yang HJ and Ye B as co-first authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-first authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-first authors best reflects this diversity. Third, Yang HJ and Ye B contributed efforts of equal substance throughout the research process. In summary, we believe that designating Yang HJ and Ye B as co-first authors is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by Sichuan Science and Technology Project, No. 2021YJ0138; Research Subject of Sichuan Provincial Health Commission, No. 19PJ007; Chengdu Science and Technology Project, No. 2021-YF05-01788-SN.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Chen, Pharmacist, Department of Pharmacy, The Affiliated Taizhou People's Hospital of Nanjing Medical University, No. 366 Taihu Road, Taizhou 225300, Jiangsu Province, China. kaichen@njmu.edu.cn
Received: October 20, 2023
Peer-review started: October 20, 2023
First decision: November 16, 2023
Revised: November 21, 2023
Accepted: December 12, 2023
Article in press: December 12, 2023
Published online: January 27, 2024
Processing time: 95 Days and 7.5 Hours
ARTICLE HIGHLIGHTS
Research background

Hepatocellular carcinoma (HCC) is a rising global health problem which represents one of the leading causes of cancer-related mortality. Although remarkable advances in treatments have been achieved for HCC, the overall prognosis is still dismal in patients, especially those at advanced stage. Several trials have focused on combining sorafenib with other systemic therapies to augment its clinical benefit.

Research motivation

Recently, a number of comparative trials worldwide have been conducted to investigate whether sorafenib/transarterial chemoembolization (TACE) combination therapy could improve clinical outcomes in patients with advanced HCC, compared with sorafenib monotherapy. However, the obtained findings are conflicting.

Research objectives

To investigate the potential synergies and safety of sorafenib plus TACE vs sorafenib alone for treating advanced HCC.

Research methods

This meta-analysis involved a large sample size to evaluate whether sorafenib plus TACE provides clinical benefit vs sorafenib monotherapy in patients with advanced HCC, in terms of overall survival (OS), progression free survival (PFS), time to progression (TTP), disease control rate (DCR), and adverse events (AEs).

Research results

It was found that patients treated with sorafenib plus TACE had better prognoses in terms of prolonged OS, PFS, and TTP, as well as increased DCR. Besides, the incidence of any AE was increased due to the addition of TACE; however, there was no significant effect on grade ≥ 3 AEs.

Research conclusions

The combination of sorafenib with TACE has superior efficacy to sorafenib monotherapy, with an acceptable safety profile.

Research perspectives

The addition of TACE to sorafenib is clinically feasible and safe in patients with advanced HCC. The positive findings of the present study might be beneficial to the management of advanced HCC. Additional randomized controlled studies are still necessary to further validating these clinical benefits.