Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysis
PurposeDiverse novel therapeutic options for hepatocellular carcinoma (HCC) have surfaced in recent years. However, it is increasingly difficult to select the optimal medication. This research aims to assess overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disea...
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Frontiers Media S.A.
2025-03-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1502931/full |
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| author | Wenjun Quan Hanifah Fazlin Zulkifli Norhafizah Saari Rafidah Hanim Shueb Rafidah Hanim Shueb Nazri Mustaffa Nazri Mustaffa |
| author_facet | Wenjun Quan Hanifah Fazlin Zulkifli Norhafizah Saari Rafidah Hanim Shueb Rafidah Hanim Shueb Nazri Mustaffa Nazri Mustaffa |
| author_sort | Wenjun Quan |
| collection | DOAJ |
| description | PurposeDiverse novel therapeutic options for hepatocellular carcinoma (HCC) have surfaced in recent years. However, it is increasingly difficult to select the optimal medication. This research aims to assess overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), adverse events (AEs), and severe adverse events (SAEs) in HCC patients receiving adjuvant therapies compared to those receiving sorafenib.MethodsFour databases were used to search articles. Only randomized controlled trials were included. Indicators such as OS, PFS, DCR, ORR, AEs and SAEs were used as outcomes. The protocol for this meta-analysis was registered with PROSPERO (Registration ID: CRD42024544394).ResultsForty trials were included in this meta-analysis. The Oxaliplatin, Fluorouracil, and Leucovorin (OFL) + sorafenib group and the sintilimab + bevacizumab biosimilar group decreased the risk of death and increased PFS, ORR, and DCR. Yet, they also yielded remarkable adverse effects and severe adverse effects. To sum up, the atezolizumab + bevacizumab combination and tepotinib were recommended due to their favorable performance on all indexes.ConclusionThis study further substantiates the efficacy of combination therapies in HCC, while they cause more toxicity in general. It is pressingly urgent to develop new drugs for liver cancer and find rational strategies to alleviate AEs.Systematic Review RegistrationPROSPERO, identifier CRD42024544394. |
| format | Article |
| id | doaj-art-fb66316eebf849589bf53f19223acdca |
| institution | DOAJ |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-fb66316eebf849589bf53f19223acdca2025-08-20T03:00:50ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-03-011610.3389/fphar.2025.15029311502931Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysisWenjun Quan0Hanifah Fazlin Zulkifli1Norhafizah Saari2Rafidah Hanim Shueb3Rafidah Hanim Shueb4Nazri Mustaffa5Nazri Mustaffa6Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of chemical pathology, School of Medical Sciences, USM, Kelantan, MalaysiaIC-Innovation in Advanced Material and Photonics, Advanced Materials Research Centre (AMREC), SIRIM Berhad, Kulim, Kedah, MalaysiaDepartment of Medical Microbiology and Parasitology, School of Medical Sciences, University Sains Malaysia, Kelantan, MalaysiaInstitute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MalaysiaDepartment of Medicine, Hospital University Sains Malaysia, Kelantan, MalaysiaPurposeDiverse novel therapeutic options for hepatocellular carcinoma (HCC) have surfaced in recent years. However, it is increasingly difficult to select the optimal medication. This research aims to assess overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), adverse events (AEs), and severe adverse events (SAEs) in HCC patients receiving adjuvant therapies compared to those receiving sorafenib.MethodsFour databases were used to search articles. Only randomized controlled trials were included. Indicators such as OS, PFS, DCR, ORR, AEs and SAEs were used as outcomes. The protocol for this meta-analysis was registered with PROSPERO (Registration ID: CRD42024544394).ResultsForty trials were included in this meta-analysis. The Oxaliplatin, Fluorouracil, and Leucovorin (OFL) + sorafenib group and the sintilimab + bevacizumab biosimilar group decreased the risk of death and increased PFS, ORR, and DCR. Yet, they also yielded remarkable adverse effects and severe adverse effects. To sum up, the atezolizumab + bevacizumab combination and tepotinib were recommended due to their favorable performance on all indexes.ConclusionThis study further substantiates the efficacy of combination therapies in HCC, while they cause more toxicity in general. It is pressingly urgent to develop new drugs for liver cancer and find rational strategies to alleviate AEs.Systematic Review RegistrationPROSPERO, identifier CRD42024544394.https://www.frontiersin.org/articles/10.3389/fphar.2025.1502931/fullhepatocellular carcinomasorafenibadjuvant therapymeta-analysissystematic review |
| spellingShingle | Wenjun Quan Hanifah Fazlin Zulkifli Norhafizah Saari Rafidah Hanim Shueb Rafidah Hanim Shueb Nazri Mustaffa Nazri Mustaffa Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysis Frontiers in Pharmacology hepatocellular carcinoma sorafenib adjuvant therapy meta-analysis systematic review |
| title | Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysis |
| title_full | Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysis |
| title_fullStr | Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysis |
| title_full_unstemmed | Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysis |
| title_short | Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: a systematic review and network meta-analysis |
| title_sort | comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma a systematic review and network meta analysis |
| topic | hepatocellular carcinoma sorafenib adjuvant therapy meta-analysis systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1502931/full |
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