Meta-analysis of rhES combined with TACE versus TACE alone for hepatocellular carcinoma: short-term therapeutic efficacy and subgroup analysis / 中华肝胆外科杂志

Objective To evaluate the short-term efficacy of recombinant human endostatin (rhES) combined with transcatheter arterial chemoembolization (TACE) versus TACE alone for intermediate and advanced primary hepatic carcinoma.Methods The relevant controlled trials about rhES plus TACE versus TACE alone in the treatment of intermediate and advanced primary hepatic carcinoma were retrieved from the databases of PubMed,Elsevier,Cochrane Library,China National Knowledge Infrastructure (CNKI),Chinese Biomedical Literature Database (CBM),Wan Fang Database.The retrieval time limited was from the database construction to January 2018,and the Meta-analysis was performed by using RevMan5.3 software.Results 18 controlled trials were included in this Meta-analysis.There were 948 cases,of which 522 cases in rhES plus TACE group and 426 cases in TACE alone group.According to the usage of rhES,the trials were further divided into intrahepatic arterial embolization group,intrahepatic arterial pump group,and intravenous infusion group.rhES plus TACE had an overall advantage over TACE alone in terms of objective response rate (ORR),and the difference was statistically significant (RR =1.59,95％CI:1.41～1.79,P＜0.05).And the ORR of rhES plus TACE in intrahepatic arterial embolization group,intrahepatic arterial pump group,intravenous infusion group was better than that of TACE alone (Intrahepatic arterial embolization group RR=1.63,95％CI:1.36～ 1.95;Intrahepatic arterial pump group RR=1.49,95％CI:1.24～1.79;Intravenous infusion group RR=1.69,95％CI:1.22～2.34),and the difference was statistically significant (P＜0.05).The subgroups analysis of anthracycline and platinum also showed that ORR in rhES plus TACE patients was better than that in TACE patients alone.Conclusion The short-term efficacy of rhES plus TACE in the treatment of intermediate and advanced primary hepatic carcinoma was better than that of TACE alone,and the same results were obtained by subgroup analysis.

Clinical research progression of molecular-targeted drugs and PD-1 inhibitors for advanced hepatocellular carcinoma / 中华肿瘤杂志

Since sorafenib has been first-line molecular-targeted drug for advanced hepatocellular carcinoma (HCC), clinical studies in the last 10 years failed to confirm that a new molecular-targeted drug or immune checkpoint inhibitor was superior or non-inferior to sorafenib, or approved second-line treatment for patients with the failure of sorafenib. However, many clinical studies published in 2017 have changed people′s previous understanding. REFLECT trial showed that as the first-line treatment of advanced HCC, lenvatinib was non-inferior than sorafenib. In addition, RESORCE trial and CheckMate-040 trial confirmed respectively that regorafenib and PD-1 inhibitor nivolumab were options of second-line treatment for patients with advanced HCC after sorafenib treatment. The development of these drugs will bring a new prospect for advanced HCC patients.