摘要
Background and Aims:In the last decade,several second-line therapies followed by sorafenib in patients with advanced hepatocellular carcinoma(HCC)have been reported.But the outcomes were different from each other.This meta-analysis aimed to evaluate the efficacy and safety of the second-line therapies followed by sorafenib in patients with advanced HCC.Methods:Embase(1974 to October 2019)and Ovid MEDLINE(1946 to October 2019)were searched for randomized clinical trials on second-line therapies followed by sorafenib in patients with advanced HCC.The quality of each study was assessed by the modified Jadad scale.Statistical analysis was carried out by RevMan5.3 software.Efficacy and safety were analyzed.Efficacy included overall survival(OS),disease control rate,time to progression,and progression-free survival.Results:Eight studies involving 3,173 patients were eligible.No difference in OS was found between the second-line treatment group and the control group(HR=0.87,95%CI:0.74-1.01,p=0.06).Disease control rate(relative risk(RR)=1.36,95%CI:1.16-1.60,p=0.0002),time to progression(HR=0.64,95%CI:0.51-0.81,p=0.0002)and progression-free survival(HR=0.60,95%CI:0.46-0.77,p<0.0001)were significantly improved by the second-line therapies.There was a slight difference in adverse events of any grade(RR=1.07,95%CI:1.00-1.14,p=0.03)between the two groups.Conclusions:These second-line therapies followed by sorafenib may potentially improve the prognosis in patients with advanced HCC.Compared with other second-line therapies,regorafenib seemed to be more effective.
基金
the National Key Technologies R&D Program under Grant No.2018YFC1106800 to KF Yuan
the Natural Science Foundation of China under Grant Nos.81972747,81872004,81800564,81770615,81700555 and 81672882 to KF Yuan
the Science and Technology Support Program of Sichuan Province under Grant Nos.2019YFQ0001,2018SZ0115 and 2017SZ0003 to KF Yuan
the Science and Technology Program of Tibet Autonomous Region under Grant No.XZ201801-GB-02 to KF Yuan
the 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University under Grant No.ZYJC18008 to KF Yuan.