First-line systemic treatment for hepatocellular carcinoma: A systematic review and network meta-analysis
Domenico Ciliberto,
Giulio Caridà,
Nicoletta Staropoli,
Caterina Romeo,
Grazia Maria Arillotta,
Cristina Napoli,
Luigia Gervasi,
Francesco Luciano,
Caterina Riillo,
Pierfrancesco Tassone,
Pierosandro Tagliaferri
Affiliations
Domenico Ciliberto
Renato Dulbecco Hospital, Catanzaro, Italy
Giulio Caridà
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Nicoletta Staropoli
Renato Dulbecco Hospital, Catanzaro, Italy; Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Caterina Romeo
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Grazia Maria Arillotta
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Cristina Napoli
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Luigia Gervasi
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Francesco Luciano
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Caterina Riillo
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
Pierfrancesco Tassone
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy; Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, USA
Pierosandro Tagliaferri
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy; Corresponding author. Department of Experimental and Clinical Medicine, Magna Graecia University, Catanzaro, Italy.
The rapid development of novel therapeutic options for advanced hepatocellular carcinoma (aHCC) has generated some uncertainty about the rational choice of the systemic upfront treatment. So far, a variety of therapeutic strategies have been investigated, including the combination of immunecheckpoint inhibitors and anti-VEGF. To identify the treatment that should be preferred as front-line approach, we compared the efficacy and toxicity of a variety of therapeutic strategies. With this aim, we performed a systematic review and a meta-analysis of randomized clinical trials. OS, PFS, ORR and tolerability outcomes were considered, and for each outcome the treatment ranking was evaluated by the surface under the cumulative rankings (SUCRAs). Combination of Camrelizumab + Rivoceranib scored the best in OS, followed by Sintilimab + Bevacizumab, whereas Lenvatinib + Pembrolizumab showed higher probability to be the best treatment in PFS and Sintilimab + Bevacizumab performed best in ORR. Finally, Durvalumab is the most tolerated treatment.
