Post-treatment adverse events ranking in targeted immunotherapy for hepatocellular carcinoma: A network meta-analysis based on risk probability assessment

Abstract

Background

Despite the rapid evolution of targeted and immunotherapies for hepatocellular carcinoma (HCC), a systematic comparison of their adverse event profiles remains limited. This review addresses this critical gap by synthesizing data from 13 randomized controlled trials (RCTs) to prioritize treatment regimens on the basis of safety, thereby guiding clinical decision-making in an era of expanding therapeutic options.

Methods

Clinical studies focusing on targeted and immunotherapies in HCC patients were chosen from databases such as PubMed, Embase, Web of Science and the Cochrane Library, which spans from 2008 to 2023. Data processing and evaluation followed PRISMA guidelines, with a random-effects model employed to merge the data. Network models were then developed, with adverse events serving as the primary endpoint for analysis.

Results

A comprehensive review of the relevant literature was conducted, identifying 13 randomized controlled trials (RCTs) encompassing 13 treatment protocols for HCC. This study included a total of 10,760 patients. Adverse events within the same category were initially consolidated, followed by the sequential construction of a network model to assess the risk probabilities associated with different targeted immunotherapy regimens for various adverse events and establish priority rankings.

Conclusions

Cabozantinib, camrelizumab, and their combination therapy for HCC are associated with a higher incidence of common adverse reactions, whereas durvalumab, lenvatinib, and their combination therapy are less likely to cause common adverse effects.