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PD-1/PD-L1 Inhibitors Plus Antiangiogenic Drugs Versus Sorafenib as the First Line Treatment for Advanced
Jun Li1, Chun Liao1, Zhaohui Liu1
1Department of General Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Technology in Cancer Research & Treatment
|December 12, 2024
Summary
PD-1/PD-L1 inhibitors plus antiangiogenic drugs (PIAD) show improved survival and response rates for advanced hepatocellular carcinoma compared to sorafenib. However, PIAD treatment is associated with a higher incidence of severe adverse events, necessitating careful monitoring.
Area of Science:
- Hepatobiliary Cancers
- Medical Oncology
- Immunotherapy
Background:
- Sorafenib is the standard treatment for advanced hepatocellular carcinoma (HCC).
- The efficacy of PD-1/PD-L1 inhibitors plus antiangiogenic drugs (PIAD) for advanced HCC is under clinical investigation.
- This study compares PIAD with sorafenib for advanced HCC.
Purpose of the Study:
- To compare the antitumor efficacy of PIAD versus sorafenib in advanced HCC.
- To evaluate the safety profiles of PIAD and sorafenib in advanced HCC treatment.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PIAD and sorafenib for advanced HCC.
- Data were extracted from six databases, focusing on overall survival (OS), progression-free survival (PFS), response rates, adverse events (AEs), and quality of life.
Main Results:
- Seven studies from four RCTs (CARES-310, COSMIC-312, IMbrave150, ORIENT-32) were analyzed.
- PIAD demonstrated significantly improved OS (HR: 0.69) and PFS (HR: 0.60) compared to sorafenib.
- PIAD also showed higher response rates and a delayed decline in quality of life, but with increased severe AEs and treatment discontinuations.
Conclusions:
- PIAD offers superior survival and response benefits over sorafenib for advanced HCC.
- The increased incidence of severe adverse events with PIAD warrants careful clinical attention and management.
