Open Access

Efficacy and safety of TACE combined with tyrosine kinase inhibitors and camrelizumab for unresectable hepatocellular carcinoma: A systematic review and meta‑analysis

  • Authors:
    • Jiahui Yu
    • Duan Yan
    • Song Wei
    • Linfeng Yang
    • Pengsheng Yi
  • View Affiliations

  • Published online on: June 26, 2024     https://doi.org/10.3892/ol.2024.14534
  • Article Number: 401
  • Copyright: © Yu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Transcatheter arterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) and camrelizumab (collectively: T‑T‑C) is a novel treatment strategy for unresectable hepatocellular carcinoma (HCC). The present systematic review and meta‑analysis aimed to evaluate the efficacy and safety of T‑T‑C compared with TACE combined with TKIs only (T‑T) in the treatment of patients with unresectable HCC. A systematic literature search was conducted on T‑T and T‑T‑C using PubMed, Embase and the Cochrane Library. Data regarding the clinical outcome, including overall survival (OS), progression‑free survival (PFS), tumor response and adverse events (AEs), were independently extracted and analyzed by two researchers using standardized protocols. In total, 7 cohort studies, including 1,798 patients (T‑T‑C, 838; T‑T, 960), were included in the meta‑analysis. The results of the present study demonstrated that the T‑T‑C group had significantly prolonged OS [hazard ratio (HR), 0.38; 95% confidence interval (CI), 0.29‑0.50; I²=61.5%; P=0.016)] and PFS (HR, 0.37; 95% CI, 0.30‑0.46; I²=44.5%; P=0.109), and showed significantly higher objective response rates [risk ratio (RR), 0.82; 95% CI, 0.69‑0.96; I²=25.1%; P=0.237)] and slightly higher disease control rates without a significant difference (RR, 0.96; 95% CI, 0.89‑1.03; I²=0.0%; P=0.969). In addition, grade 3/4 AEs were more common in the T‑T group, including hypertension (RR, 1.15; 95% CI, 0.85‑1.56), vomiting or nausea (RR, 0.88; 95% CI, 0.44‑1.76) and pain (RR, 0.74; 95% CI, 0.45‑1.21); however, these results were not statistically significant. In conclusion, compared with T‑T combination therapy, T‑T‑C demonstrated a notable advantage in terms of OS, PFS, ORR and DCR in patients with unresectable HCC. For manageable AEs, although the results were not statistically significant, the incidence of AEs in the T‑T group was higher than that in the T‑T‑C group in terms of event probability.
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Spandidos Publications style
Yu J, Yan D, Wei S, Yang L and Yi P: Efficacy and safety of TACE combined with tyrosine kinase inhibitors and camrelizumab for unresectable hepatocellular carcinoma: A systematic review and meta‑analysis. Oncol Lett 28: 401, 2024
APA
Yu, J., Yan, D., Wei, S., Yang, L., & Yi, P. (2024). Efficacy and safety of TACE combined with tyrosine kinase inhibitors and camrelizumab for unresectable hepatocellular carcinoma: A systematic review and meta‑analysis. Oncology Letters, 28, 401. https://doi.org/10.3892/ol.2024.14534
MLA
Yu, J., Yan, D., Wei, S., Yang, L., Yi, P."Efficacy and safety of TACE combined with tyrosine kinase inhibitors and camrelizumab for unresectable hepatocellular carcinoma: A systematic review and meta‑analysis". Oncology Letters 28.2 (2024): 401.
Chicago
Yu, J., Yan, D., Wei, S., Yang, L., Yi, P."Efficacy and safety of TACE combined with tyrosine kinase inhibitors and camrelizumab for unresectable hepatocellular carcinoma: A systematic review and meta‑analysis". Oncology Letters 28, no. 2 (2024): 401. https://doi.org/10.3892/ol.2024.14534