Abstract 177P
Background
Lenvatinib and sorafenib are tyrosine kinase inhibitors that are effective in the treatment of unresectable hepatocellular carcinoma (HCC). Therefore, the aim of this study was to compare the effectiveness of transarterial chemoembolization (TACE) combined with lenvatinib (TACE-lenvatinib) and TACE combined with sorafenib (TACE-sorafenib) in the treatment of unresectable HCC.
Methods
Publicly available studies comparing the efficacy of TACE-lenvatinib and TACE-sorafenib in the treatment of unresectable HCC were collected from PubMed, Embase and Cochrane Library, with a cut-off date of February 2024. Stata SE 15 software was used for statistical analysis.
Results
A total of six studies involving 547 patients were included, 248 in the TACE-lenvatinib group and 299 in the TACE-sorafenib group. Meta-analysis results showed that TACE-lenvatinib was more effective than TACE-sorafenib in complete response (RR = 1.81, 95% CI: 1.11, 2.96, P = 0.02), partial response (RR = 1.38, 95% CI: 1.12, 1.70, P = 0.002), objective response rate (RR = 1.47, 95% CI: 1.24, 1.74, P < 0.0001) and disease control rate (RR = 1.22, 95% CI: 1.00, 1.49, P = 0.05). TACE-lenvatinib was significantly lower than TACE-sorafenib in progressive disease rate (RR = 0.54, 95% CI: 0.39, 0.74, P = 0.002). No significant difference was found in stable disease rate (RR=0.89, 95%CI:0.60, 1.33, P=0.58) between the two groups. TACE-lenvatinib was significantly more effective than TACE-sorafenib in overall survival (HR = 2.00, 95%CI: 1.59, 2,50, P < 0.05) and progression free survival (HR = 2.04, 95% CI: 1.49, 2.86, P < 0.05). TACE-lenvatinib was better in reducing hypertension than TACE-sorafenib, while no significant difference was found in overall adverse events, abdominal pain, fever, fatigue, nausea and vomiting, decreased appetite, liver dysfunction, hand-foot skin reaction, diarrhea, thrombocytopenia, and rash between the two groups.
Conclusions
In patients with unresectable HCC, TACE-lenvatinib induced a better tumor response rate and survival outcome than TACE-sorafenib, while TACE-lenvatinib induced a higher incidence of hypertension than TACE-sorafenib.
Editorial acknowledgement
MogoEdit for its English editing during the preparation of this manuscript.
Legal entity responsible for the study
The authors.
Funding
This research was supported by the Shenzhen High-Level Hospital Construction Fund, the Sanming Project of Medicine in Shenzhen (SZSM202011010).
Disclosure
All authors have declared no conflicts of interest.