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Updated: Sep 16, 2025
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Efficacy of systemic therapy for advanced hepatocellular carcinoma based on etiology: A systematic review and network
Charlene Hoi Lam Wong1, Kenneth Sik Kwan Chan1, Regina Cheuk Lam Lo2
1Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
Background:
Robust comparative data on the treatment efficacy of hepatocellular carcinoma (HCC) based on disease etiology are lacking. We conducted a network meta-analysis (NMA) and pairwise meta-analysis to evaluate the survival of patients with advanced HCC treated with systemic therapies based on etiology.
Methods:
PubMed/MEDLINE Ovid, Embase, Cochrane Library, CINAHL Databases, and trial registries were systematically searched for relevant studies from 1 January 2009 and 6 June 2024. Phase III randomized controlled trials of systemic therapies in advanced HCC patients with survival outcomes reported in at least one of the three etiology subgroups (hepatitis B virus
Results:
A total of 29 RCTs encompassing 18,229 patients were included. In first-line trials. Atezolizumab + bevacizumab (atezo-bev) (P-score, 87 %) and STRIDE (P-score, 75 %) yielded the best OS benefits among all approved regimens in the HBV population; atezo-bev (P-score, 94 %) ranked the best in HCV patients. For non-viral aetiology, STRIDE (P-score, 79 %) ranked the best whereas atezo-bev (P-score, 29 %) ranked the worst. Pairwise MA showed that ICI + VEGF/VEGFRi has significantly different HR compared to control (sorafenib) in different etiology (HBV: 0.65, HCV: 0.72, and non-viral: 0.98, p = 0.01), while ICI has consistent HR compared to control irrespective of disease etiology (HBV: 0.81, HCV: 0.79, non-viral: 0.83, p = 0.94).
Conclusion:
Treatment efficacy of advanced HCC is affected by underlying liver disease. The survival benefit of ICI + VEGF/VEGFRi was mainly seen in viral-HCC.
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