{"title":"经动脉化疗栓塞联合酪氨酸激酶抑制剂和程序性死亡受体-1抑制剂治疗不可切除的肝细胞癌：一项系统综述和荟萃分析","authors":"Yonghong He, Yuexi Liu, Jie Xu, Yanan He","doi":"10.21037/tcr-2025-798","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>More than 60% of patients with hepatocellular carcinoma (HCC) are diagnosed at the intermediate-advanced stages, which are not amenable to surgical resection and ablation. The optimal treatment plan for patients with unresectable HCC remains controversial. This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKI) plus programmed death receptor-1 (PD-1) inhibitors (TACE + TKI + PD-1) versus TACE combined with TKI (TACE + TKI) among patients with unresectable HCC.</p><p><strong>Methods: </strong>A comprehensive search of the PubMed, EMBASE and the Cochrane Library databases was performed, and all studies related to TACE + TKI + PD-1 and TACE + TKI for treatment of HCC were included. We calculated risk ratio (RR) and mean difference for dichotomous and continuous outcomes. Data were analyzed using RevMan5.4 and Stata 17.0. We conducted a subgroup analysis based on specific types of TKI.</p><p><strong>Results: </strong>A total of 12 retrospective studies were included in the analysis, involving 1,078 patients in the TACE + TKI + PD-1 group and 1,332 in the TACE + TKI group. Compared with the TACE + TKI group, the TACE + TKI + PD-1 group showed prolonged overall survival [RR =7.39, 95% confidence interval (CI): 5.69-9.08, P<0.001, I<sup>2</sup>=90%], progression-free survival (RR =3.89, 95% CI: 3.21-4.57, P<0.001, I<sup>2</sup>=81%)and higher objective response rate (RR =1.38, 95% CI: 1.26-1.51, P<0.001, I<sup>2</sup>=49%). Similarly, the 1-year survival rate improved (RR =5.92, 95% CI: 4.43-5.92, P<0.001, I<sup>2</sup>=11%) in the TACE + TKI + PD-1 group. No significant difference was found in adverse events between the two groups.</p><p><strong>Conclusions: </strong>TACE + TKI + PD-1 significantly improved survival outcomes and demonstrated superior efficacy and a manageable safety profile in the systemic treatment of patients with unresectable HCC.</p>","PeriodicalId":23216,"journal":{"name":"Translational cancer research","volume":"14 8","pages":"4976-4988"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432782/pdf/","citationCount":"0","resultStr":"{\"title\":\"Transarterial chemoembolization combined with tyrosine kinase inhibitors and programmed death receptor-1 inhibitors for unresectable hepatocellular carcinoma: a systematic review and meta-analysis.\",\"authors\":\"Yonghong He, Yuexi Liu, Jie Xu, Yanan He\",\"doi\":\"10.21037/tcr-2025-798\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>More than 60% of patients with hepatocellular carcinoma (HCC) are diagnosed at the intermediate-advanced stages, which are not amenable to surgical resection and ablation. The optimal treatment plan for patients with unresectable HCC remains controversial. This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKI) plus programmed death receptor-1 (PD-1) inhibitors (TACE + TKI + PD-1) versus TACE combined with TKI (TACE + TKI) among patients with unresectable HCC.</p><p><strong>Methods: </strong>A comprehensive search of the PubMed, EMBASE and the Cochrane Library databases was performed, and all studies related to TACE + TKI + PD-1 and TACE + TKI for treatment of HCC were included. We calculated risk ratio (RR) and mean difference for dichotomous and continuous outcomes. Data were analyzed using RevMan5.4 and Stata 17.0. We conducted a subgroup analysis based on specific types of TKI.</p><p><strong>Results: </strong>A total of 12 retrospective studies were included in the analysis, involving 1,078 patients in the TACE + TKI + PD-1 group and 1,332 in the TACE + TKI group. Compared with the TACE + TKI group, the TACE + TKI + PD-1 group showed prolonged overall survival [RR =7.39, 95% confidence interval (CI): 5.69-9.08, P<0.001, I<sup>2</sup>=90%], progression-free survival (RR =3.89, 95% CI: 3.21-4.57, P<0.001, I<sup>2</sup>=81%)and higher objective response rate (RR =1.38, 95% CI: 1.26-1.51, P<0.001, I<sup>2</sup>=49%). Similarly, the 1-year survival rate improved (RR =5.92, 95% CI: 4.43-5.92, P<0.001, I<sup>2</sup>=11%) in the TACE + TKI + PD-1 group. No significant difference was found in adverse events between the two groups.</p><p><strong>Conclusions: </strong>TACE + TKI + PD-1 significantly improved survival outcomes and demonstrated superior efficacy and a manageable safety profile in the systemic treatment of patients with unresectable HCC.</p>\",\"PeriodicalId\":23216,\"journal\":{\"name\":\"Translational cancer research\",\"volume\":\"14 8\",\"pages\":\"4976-4988\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432782/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Translational cancer research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/tcr-2025-798\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational cancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tcr-2025-798","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/28 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Transarterial chemoembolization combined with tyrosine kinase inhibitors and programmed death receptor-1 inhibitors for unresectable hepatocellular carcinoma: a systematic review and meta-analysis.
Background: More than 60% of patients with hepatocellular carcinoma (HCC) are diagnosed at the intermediate-advanced stages, which are not amenable to surgical resection and ablation. The optimal treatment plan for patients with unresectable HCC remains controversial. This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKI) plus programmed death receptor-1 (PD-1) inhibitors (TACE + TKI + PD-1) versus TACE combined with TKI (TACE + TKI) among patients with unresectable HCC.
Methods: A comprehensive search of the PubMed, EMBASE and the Cochrane Library databases was performed, and all studies related to TACE + TKI + PD-1 and TACE + TKI for treatment of HCC were included. We calculated risk ratio (RR) and mean difference for dichotomous and continuous outcomes. Data were analyzed using RevMan5.4 and Stata 17.0. We conducted a subgroup analysis based on specific types of TKI.
Results: A total of 12 retrospective studies were included in the analysis, involving 1,078 patients in the TACE + TKI + PD-1 group and 1,332 in the TACE + TKI group. Compared with the TACE + TKI group, the TACE + TKI + PD-1 group showed prolonged overall survival [RR =7.39, 95% confidence interval (CI): 5.69-9.08, P<0.001, I2=90%], progression-free survival (RR =3.89, 95% CI: 3.21-4.57, P<0.001, I2=81%)and higher objective response rate (RR =1.38, 95% CI: 1.26-1.51, P<0.001, I2=49%). Similarly, the 1-year survival rate improved (RR =5.92, 95% CI: 4.43-5.92, P<0.001, I2=11%) in the TACE + TKI + PD-1 group. No significant difference was found in adverse events between the two groups.
Conclusions: TACE + TKI + PD-1 significantly improved survival outcomes and demonstrated superior efficacy and a manageable safety profile in the systemic treatment of patients with unresectable HCC.
期刊介绍：
Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.
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