Lenvatinib Versus Atezolizumab Plus Bevacizumab in the First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Meta-Analysis of Real-World Studies.
Target Oncol
; 19(2): 203-212, 2024 Mar.
Article
in En
| MEDLINE
| ID: mdl-38289445
ABSTRACT
BACKGROUND:
Immunotherapy has revolutionized the treatment of hepatocellular carcinoma (HCC). However, whether adding immunotherapy to antiangiogenic therapy benefits patients with unresectable HCC (uHCC) more in the first-line setting remains controversial.OBJECTIVE:
In this analysis, we compared the clinical outcomes of lenvatinib monotherapy with atezolizumab plus bevacizumab combination therapy in advanced uHCC in real-world clinical practice.METHODS:
The MEDLINE, Embase, and Cochrane CENTRAL databases were systematically searched on 23 April 2023. The "metaSurvival" and "meta" packages of the R software (version 4.2.2) were used to summarize the survival curves and meta-analyze the survival data. Overall survival (OS) and progression-free survival (PFS) were defined as dual primary endpoints. Secondary endpoints included the objective response rate (ORR) and disease control rate (DCR).RESULTS:
Overall, the pooled median OS was 18.4 months in the lenvatinib group versus 18.5 months in the atezolizumab plus bevacizumab group; the pooled median PFS was 6.9 months in the lenvatinib group versus 7.3 months in the atezolizumab plus bevacizumab group. Lenvatinib therapy showed similar OS [hazard ratio (HR) 0.91, 95% confidence interval (CI) 0.55-1.52, p = 0.72] and PFS (HR 0.79, 95% CI 0.56-1.12, p = 0.19) compared with atezolizumab plus bevacizumab therapy. In addition, a comparable ORR [odds ratio (OR) 0.89, 95% CI 0.65-1.20, p = 0.44) was observed between lenvatinib and atezolizumab plus bevacizumab.CONCLUSIONS:
Comprehensive analysis suggested that lenvatinib monotherapy exhibited survival outcomes comparable to those of atezolizumab plus bevacizumab combination therapy, which may provide useful insights for clinicians in future clinical practice.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Phenylurea Compounds
/
Quinolines
/
Carcinoma, Hepatocellular
/
Antibodies, Monoclonal, Humanized
/
Liver Neoplasms
Type of study:
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Target Oncol
Journal subject:
NEOPLASIAS
Year:
2024
Type:
Article
Affiliation country:
China