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Published on: September 30, 2021
Molecular targeted agents as second-line treatment for hepatocellular carcinoma: a meta-analysis and review
Jung Han Kim1, Bum Jun Kim1,2, Hyun Joo Jang3
1Division of Hemato-Oncology, Department of Internal Medicine, Kangnam Sacred-Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul 07441, Republic of Korea.
Abstract:
It is unclear whether targeted agents can produce survival advantage in patients with advanced HCC previously treated with sorafenib. We performed this meta-analysis of randomized trials and reviewed clinical outcomes of molecular targeted agents in the second-line treatment for advanced HCC. A systematic computerized search of the electronic databases PubMed, Embase, Google Scholar, and Cochrane Library (up to May 2017) was carried out. From six studies, 2,388 patients were included in the meta-analysis. Almost all patients were treated with sorafenib as first-line therapy. Compared with placebo, targeted agents significantly improved time-to-progression (hazard ratio = 0.62, 95% confidence interval: 0.49-0.78, P < 0.0001). In terms of overall survival, targeted therapy tended to improve prognosis (hazard ratio = 0.86, 95% confidence interval: 0.74-1.01, P = 0.06). In conclusion, this meta-analysis indicates that molecular targeted agents have a potential to improve prognosis after failure of first-line treatment with sorafenib in patients with advanced HCC.
Insights
Molecular targeted agents show promise for advanced hepatocellular carcinoma (HCC) patients post-sorafenib treatment. This meta-analysis suggests improved progression-free survival and a trend towards better overall survival, offering new hope for HCC treatment.
Area of Science:
- Hepatobiliary Oncology
- Clinical Pharmacology
- Evidence Synthesis
Background:
- Advanced hepatocellular carcinoma (HCC) presents challenges in second-line treatment following sorafenib failure.
- The survival benefit of targeted agents in this patient population remains uncertain.
Purpose of the Study:
- To evaluate the efficacy of molecular targeted agents as second-line therapy for advanced HCC.
- To assess the impact on overall survival and time-to-progression in patients previously treated with sorafenib.
Main Methods:
- Meta-analysis of randomized controlled trials.
- Systematic literature search of PubMed, Embase, Google Scholar, and Cochrane Library up to May 2017.
- Inclusion of six studies with 2,388 patients, predominantly treated with first-line sorafenib.
Main Results:
- Targeted agents significantly improved time-to-progression compared to placebo (HR = 0.62, P < 0.0001).
- A trend towards improved overall survival was observed with targeted therapy (HR = 0.86, P = 0.06).
Conclusions:
- Molecular targeted agents demonstrate potential in improving prognosis for advanced HCC patients after sorafenib treatment failure.
- These findings support the consideration of targeted therapies in the second-line setting for advanced HCC.
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