Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 21, 2021; 27(19): 2415-2433
Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2415
Selection of first-line systemic therapies for advanced hepatocellular carcinoma: A network meta-analysis of randomized controlled trials
Yue Han, Wei-Hua Zhi, Fei Xu, Chen-Bo Zhang, Xiao-Qian Huang, Jian-Feng Luo
Yue Han, Wei-Hua Zhi, Fei Xu, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Chen-Bo Zhang, Xiao-Qian Huang, Jian-Feng Luo, Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200034, China
Author contributions: Han Y, Zhi WH, and Xu F made contributions to the literature search; Zhi WH and Xu F were involved in figure preparation; Han Y and Luo JF made contributions to the study design; Luo JF and Huang XQ were involved in collecting the data; Luo JF, Huang XQ, and Zhang CB were involved in analyzing the data; Han Y, Luo JF, and Zhi WH made contributions to the data interpretation; Han Y and Zhi WH were involved in manuscript writing; Zhang CB and Han Y made contributions to the verification of the data.
Conflict-of-interest statement: The authors have no declarations of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yue Han, PhD, Doctor, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan 3rd Alley, Dongcheng District, Beijing 100021, China. doctorhan@163.com
Received: January 26, 2021
Peer-review started: January 26, 2021
First decision: February 27, 2021
Revised: March 10, 2021
Accepted: April 21, 2021
Article in press: April 21, 2021
Published online: May 21, 2021
Core Tip

Core Tip: The present network meta-analysis is the first to compare data from randomized trials of all first-line systemic therapies for hepatocellular carcinoma including chemotherapy, targeted drugs, immunotherapy, and combination therapies. Furthermore, the analysis represents a comprehensive cross comparison of outcomes, including tumor response rates, survival, and safety and included a sub-analysis in patients with hepatitis B virus infection. Our results showed that atezolizumab plus bevacizumab was ranked first for progression-free survival and overall survival but also had the highest rate of discontinuations due to adverse events. Lenvatinib ranked first for overall response rate and second for progression-free survival.