Interventional therapy combined with tyrosine kinase inhibitors with or without immune checkpoint inhibitors as initial treatment for hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysis

作者全名：Du, Changjie; Wu, Hongyu; Zhong, Tao; Zhai, Qilong; Yuan, Jiajun; Peng, Jialun; Ma, Rong; Li, Jinzheng

作者地址：[Du, Changjie; Wu, Hongyu; Zhong, Tao; Zhai, Qilong; Yuan, Jiajun; Peng, Jialun; Ma, Rong; Li, Jinzheng] Chongqing Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China

通信作者：Ma, R; Li, JZ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China.

来源：DISCOVER ONCOLOGY

ESI学科分类：　

WOS号：WOS:001222603200002

JCR分区：Q2

影响因子：2.8

年份：2024

卷号：15

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Hepatocellular carcinoma; Portal vein tumor thrombosis; Interventional therapy; Tyrosine kinase inhibitors; Immune checkpoint inhibitors

摘要：Background Interventional therapy, in conjunction with tyrosine kinase inhibitors (TKIs), has shown promising outcomes for treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). With the advent of immunotherapy, the combined use of immune checkpoint inhibitors (ICIs) has attracted great attention due to their potential effectiveness in advanced HCC. This study aims to compare the efficacy and safety of a triple therapy regimen (Interventional therapy, TKIs and ICIs, IT-TKI-ICI) with a dual therapy regimen (Interventional therapy and TKIs, IT-TKI) in the treatment of HCC and PVTT (HCC-PVTT).Methods A comprehensive search was carried out in PubMed, Web of Science, Embase, Scopus, and the Cochrane Library databases. Primary outcome measures were overall survival (OS) and progression-free survival (PFS), while secondary outcomes included tumor response rate, adverse event incidence as well as downstaging surgery rate. Statistical analysis was conducted using Revman 5.4 software.Results The meta-analysis finally included 6 cohort studies. The triple therapy group demonstrated significantly prolonged OS and PFS compared to the dual therapy group. Meanwhile, the former exhibited significantly higher rates of objective response rate (ORR), disease control rate (DCR) and better downstaging effects with a higher salvage surgery rate without significantly increasing adverse events.Conclusion In comparison to dual therapy, the triple therapy with interventional therapy, TKIs, and ICIs demonstrates superior efficacy and equivalent safety for HCC-PVTT.

基金机构：Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University; Senior Medical Talents Program of Chongqing for Young and Middle-aged; Chongqing Natural Science Foundation [CSTB2022NSCQ-MSX0821]; Joint project of Chongqing Health Commission and Science and Technology Bureau [2022GDRC004]

基金资助正文：Funding for the study was provided by the Kuanren Talents Program of the second affiliated hospital of Chongqing Medical University (Jinzheng Li), Senior Medical Talents Program of Chongqing for Young and Middle-aged (Jinzheng Li), Chongqing Natural Science Foundation (NO: CSTB2022NSCQ-MSX0821, Jinzheng Li) and Joint project of Chongqing Health Commission and Science and Technology Bureau (NO: 2022GDRC004, Jinzheng Li)