PDF(Pubmed)
Abstract：
UNASSIGNED: Studies comparing atezolizumab plus bevacizumab (ATE/BEV) vs. lenvatinib (LEN) for advanced hepatocellular carcinoma (aHCC) have shown conflicting results. With this background, we aimed to collate the available evidence comparing ATE/BEV and LEN in aHCC.
UNASSIGNED: A comprehensive search of three databases was conducted from inception to November 2022 for studies comparing ATE/BEV with LEN for managing aHCC. Results were presented with their 95% confidence intervals (95% CI) as the hazard ratio (HR) for time-to-event outcomes or odds ratios (OR) for dichotomous outcomes.
UNASSIGNED: A total of 8 studies were included. On analysis of matched cohorts, there was no difference in the objective response rate (ORR) (adjusted odds ratio [aOR] = 1.15, 95% CI: 0.83-1.61) or disease control rate (DCR) (aOR = 0.83, 95% CI: 0.49-1.38) between groups. Three studies reported a significantly longer progression-free survival (PFS) with ATE/LEN, while one reported a longer PFS with LEN. The adjusted hazard ratio (aHR) for PFS available from three studies was comparable (HR = 1.06, 95% CI: 0.75-1.50). Data were insufficient to carry out a formal analysis for overall survival (OS), but none of the studies reported any difference in OS. On comparison of overall adverse events (AE) and ≥ grade 3 AE, there was no difference in the overall analysis, but higher risk of AE with LEN on sensitivity analysis.
UNASSIGNED: Based on the currently available literature, LEN was found to be non-inferior to ATE/BEV in terms of ORR, DCR, and PFS. However, LEN may be associated with a higher incidence of AEs. Further head-to-head trials are required to demonstrate the superiority of ATE/BEV over LEN.
UNASSIGNED: A comprehensive search of three databases was conducted from inception to November 2022 for studies comparing ATE/BEV with LEN for managing aHCC. Results were presented with their 95% confidence intervals (95% CI) as the hazard ratio (HR) for time-to-event outcomes or odds ratios (OR) for dichotomous outcomes.
UNASSIGNED: A total of 8 studies were included. On analysis of matched cohorts, there was no difference in the objective response rate (ORR) (adjusted odds ratio [aOR] = 1.15, 95% CI: 0.83-1.61) or disease control rate (DCR) (aOR = 0.83, 95% CI: 0.49-1.38) between groups. Three studies reported a significantly longer progression-free survival (PFS) with ATE/LEN, while one reported a longer PFS with LEN. The adjusted hazard ratio (aHR) for PFS available from three studies was comparable (HR = 1.06, 95% CI: 0.75-1.50). Data were insufficient to carry out a formal analysis for overall survival (OS), but none of the studies reported any difference in OS. On comparison of overall adverse events (AE) and ≥ grade 3 AE, there was no difference in the overall analysis, but higher risk of AE with LEN on sensitivity analysis.
UNASSIGNED: Based on the currently available literature, LEN was found to be non-inferior to ATE/BEV in terms of ORR, DCR, and PFS. However, LEN may be associated with a higher incidence of AEs. Further head-to-head trials are required to demonstrate the superiority of ATE/BEV over LEN.
摘要：
■比较阿妥珠单抗加贝伐单抗（ATE/BEV）与乐伐替尼（LEN）治疗晚期肝细胞癌（aHCC）的结果相互矛盾。在这样的背景下,我们旨在整理在aHCC中比较ATE/BEV和LEN的现有证据。
■从成立到2022年11月，对三个数据库进行了全面搜索，以比较ATE/BEV与LEN管理aHCC的研究。结果以其95％置信区间（95％CI）作为时间至事件结局的风险比（HR）或二分结局的比值比（OR）。
■共纳入8项研究。在对匹配队列的分析中，两组间客观缓解率(ORR)(校正比值比[aOR]=1.15,95%CI:0.83-1.61)或疾病控制率(DCR)(aOR=0.83,95%CI:0.49-1.38)无差异.三项研究报告了ATE/LEN的无进展生存期（PFS）显着延长，而其中一人报告LEN的PFS较长。来自三项研究的PFS的校正风险比（aHR）具有可比性（HR=1.06，95％CI：0.75-1.50）。数据不足以对总生存期(OS)进行正式分析，但没有一项研究报告OS有任何差异。在总体不良事件（AE）和≥3级AE的比较中，总体分析没有差异，但敏感性分析上LEN的AE风险较高。
■根据现有文献，在ORR方面，LEN被发现不劣于ATE/BEV，DCR,和PFS。然而,LEN可能与较高的AE发生率相关。需要进一步的头对头试验来证明ATE/BEV优于LEN。
■从成立到2022年11月，对三个数据库进行了全面搜索，以比较ATE/BEV与LEN管理aHCC的研究。结果以其95％置信区间（95％CI）作为时间至事件结局的风险比（HR）或二分结局的比值比（OR）。
■共纳入8项研究。在对匹配队列的分析中，两组间客观缓解率(ORR)(校正比值比[aOR]=1.15,95%CI:0.83-1.61)或疾病控制率(DCR)(aOR=0.83,95%CI:0.49-1.38)无差异.三项研究报告了ATE/LEN的无进展生存期（PFS）显着延长，而其中一人报告LEN的PFS较长。来自三项研究的PFS的校正风险比（aHR）具有可比性（HR=1.06，95％CI：0.75-1.50）。数据不足以对总生存期(OS)进行正式分析，但没有一项研究报告OS有任何差异。在总体不良事件（AE）和≥3级AE的比较中，总体分析没有差异，但敏感性分析上LEN的AE风险较高。
■根据现有文献，在ORR方面，LEN被发现不劣于ATE/BEV，DCR,和PFS。然而,LEN可能与较高的AE发生率相关。需要进一步的头对头试验来证明ATE/BEV优于LEN。
