Abstract 180P
Background
Despite the remarkable evolution of its therapeutic landscape, hepatocellular carcinoma (HCC) remains the third cause of cancer-related deaths. Over the last years, tyrosine kinase inhibitors (TKIs)-based systemic therapy prevails as a standard treatment for advanced HCC. To fully understand TKIs success, our objective was to evaluate the clinical effectiveness and the associated toxicity of approved and unapproved TKIs in the treatment of advanced HCC patients.
Methods
We performed a systematic review with meta-analysis of randomized controlled clinical trials registered in 17 databases until January 31st 2023. Clinical trials that met the eligibility criteria and evaluated prognosis, tumor response and the presence of serious adverse events (AEs) in HCC patients after TKI treatment vs. placebo were included in meta-analysis. Global effects data were extracted or estimated by Parmar method and analyzed employing STATA 16 software. Moreover, heterogeneity, source of heterogeneity and publication bias were assessed.
Results
Twelve studies comprising a total of 5672 HCC patients were selected for meta-analysis. Results revealed that TKI treatment was positively correlated with overall survival, progression-free survival and time to progression. Furthermore, the objective response rate and disease control rate were also significantly associated with TKIs, exhibiting their positive clinical benefit. However, AEs such as dehydration, diarrhea and hepatic encephalopathy showed a marked relation to TKI treatment in HCC patients, denoting the presence of an important toxicity associated to TKIs.
Conclusions
Overall, results from meta-analysis demonstrate the relevant clinical benefits of using TKIs for advanced HCC treatment. Despite the presence of mild or moderate AEs, these can be managed using appropriate clinical strategies to maximize the efficacy of treatment and minimize its associated toxicity.
Legal entity responsible for the study
The authors.
Funding
Ministry of Science and Innovation, Spain.
Disclosure
All authors have declared no conflicts of interest.