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Sorafenib enhances effects of transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Background and aim

Combination therapy of sorafenib and transarterial chemoembolization (TACE) showed benefits for hepatocellular carcinoma (HCC). This systematic review aims for evaluation of efficacy and safety between sorafenib plus TACE and TACE alone for HCC.

Methods

We systematically searched multi-databases to identify eligible studies. Studies comparing sorafenib combined with TACE and TACE alone for HCC were included.

Results

Nine studies with 900 patients (sorafenib + TACE = 446, TACE = 454) were finally included. Sorafenib combined with TACE significantly reduced 6-month mortality [OR 0.24, 95 % confidential interval (CI) 0.09–0.68, P = 0.007] and 1-year mortality (OR 0.35, 95 % CI 0.21–0.56, P < 0.0001), but did not decrease 2-year mortality (OR 0.58, 95 % CI 0.14–2.46, P = 0.46). Although combination therapy tend to reduce 3-month (OR 0.76, 95 % CI 0.52–1.10, P = 0.15) and 6-month progression free rate (OR 0.27, 95 % CI 0.07–1.05, P = 0.06), the changes were not significant. Additionally, objective response ratio (OR 0.39, 95 % CI 0.19–0.78, P = 0.008) and clinical benefit ratio (OR 0.27, 95 % CI 0.15–0.50, P < 0.0001) also favored for combination therapy, which, however, caused higher morbidity, especially hand-foot skin reaction (OR 53.71, 95 % CI 28.86–99.93, P < 0.00001), hematological events (OR 14.8, 95 % CI 6.07–36.07, P < 0.00001), diarrhea (OR 6.62, 95 % CI 3.82–11.45, P < 0.00001), hypertension (OR 5.03, 95 % CI 3.02–8.38, P < 0.00001), rash/desquamation (OR 5.67, 95 % CI 3.58–8.99, P < 0.00001), and fatigue (OR 2.5, 95 % CI 1.09–5.72, P = 0.03).

Conclusion

Combination of sorafenib and TACE showed survival and clinical benefits in patients with HCC, though enhanced morbidity.

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Acknowledgments

Supported by National Natural Science Funds for Distinguished Young Scholar, No. 30925033; National Natural Science Funds of China, No. 30801101 and No. 81171884; Innovation and High-Level Talent Training Program of Department of Health of Zhejiang.

Conflict of interest

No potential conflict of interest relevant to this article was reported.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China

    Qi-Han Fu, Qi Zhang, Xue-Li Bai, Qi-Da Hu, Wei Su, Yi-Wen Chen, Ri-Ga Su & Ting-Bo Liang

  2. Key Laboratory of Cancer Prevention and Intervention, the Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China

    Qi Zhang, Xue-Li Bai & Ting-Bo Liang

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  1. Qi-Han Fu
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Correspondence to Ting-Bo Liang.

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Qi-Han Fu and Qi Zhang have contributed equally to this work.

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Fu, QH., Zhang, Q., Bai, XL. et al. Sorafenib enhances effects of transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis. J Cancer Res Clin Oncol 140, 1429–1440 (2014). https://doi.org/10.1007/s00432-014-1684-5

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  • DOI: https://doi.org/10.1007/s00432-014-1684-5

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