A systematic literature review and network meta-analysis of first-line treatments for unresectable hepatocellular carcinoma based on data from randomized controlled trials
| Autor: | Suki Shergill, Fabien Colaone, Richard F Pollock, Victoria K Brennan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology Sorafenib medicine.medical_specialty Carcinoma Hepatocellular Brachytherapy Antineoplastic Agents law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans Pharmacology (medical) Yttrium Radioisotopes Chemoembolization Therapeutic neoplasms Randomized Controlled Trials as Topic business.industry Selective internal radiation therapy Hazard ratio Liver Neoplasms medicine.disease digestive system diseases Progression-Free Survival Survival Rate 030104 developmental biology Systematic review chemistry 030220 oncology & carcinogenesis Hepatocellular carcinoma Meta-analysis Lenvatinib business medicine.drug |
| Zdroj: | Expert review of anticancer therapy. 21(3) |
| ISSN: | 1744-8328 |
| Popis: | Background Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. First-line treatment options for unresectable HCC include sorafenib, lenvatinib, selective internal radiation therapy (SIRT), and transarterial chemoembolization (TACE). The present study reviewed randomized controlled trials (RCTs) of first-line therapies for unresectable HCC in TACE-ineligible patients. Research design and methods A systematic literature review (SLR) was conducted to identify RCTs of first-line treatments for TACE-ineligible patients with unresectable HCC. Data on overall survival (OS) and progression-free survival were extracted and a contrast-based Bayesian network meta-analysis (NMA) was conducted using Markov Chain Monte Carlo techniques. Results The SLR identified three RCTs: two comparing Y-90 resin microspheres with sorafenib, and one comparing sorafenib with lenvatinib. No RCTs were identified comparing other SIRT technologies with any other approved first-line HCC therapies. The NMA showed no significant OS differences between Y-90 resin microspheres and sorafenib (hazard ratio [HR] 0.92, 95% credible interval [CrI]: 0.79-1.08) or lenvatinib (HR: 0.88, 95% CrI: 0.63-1.22). Conclusions An SLR and NMA showed no significant differences between sorafenib, lenvatinib, and Y-90 resin microspheres in treating unresectable HCC. RCT evidence was not available for any other SIRT technologies and an evaluation of their relative efficacy was therefore not possible. |
| Databáze: | OpenAIRE |
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