Transarterial chemoembolization combined with lenvatinib vs transarterial chemoembolization combined with sorafenib for unresectable hepatocellular carcinoma: A systematic review and meta-analysis

Table 1 Basic characteristics and quality assessment of included studies

Ref.	Country	Period	Medical center	Study type	TACE + LEN vs TACE + SOR, n	Gender (F/M), TACE + LEN	Gender (F/M), TACE + SOR	Age, TACE + LEN	Age, TACE + SOR	Quality
Ding et al[15], 2021	China	2018-2020	Beijing Ditan Hospital	R	32 vs 32	7/25	5/27	57 ± 11	56 ± 11	5
Xue et al[16], 2021	China	2017-2020	First Affiliated Hospital of Sun Yat-Sen University	RCT	50 vs 100	4/46	3/97	54 (49-61)	54 (49-63)	6
Xu et al[17], 2023	China	2019-2021	First Affiliated Hospital of Anhui Medical University	R	43 vs 41	18/25	17/24	55 ± 12.26	52.5 ± 11.47	6
Yang et al[18], 2021	China	2017-2020	West China Medical School	R	38 vs 38	4/34	4/34	55.18 ± 10.94	54.39 ± 12.17	NA
Zhang et al[19], 2022	China	2018-2021	The First Affiliated Hospital with Nanjing Medical University	R	53 vs 59	9/44	7/52	57.7 ± 11.8	58.8 ± 11.1	7
Zhao et al[20], 2022	China	2018-2020	Chinese People’s Liberation Army General Hospital, Beijing	R	32 vs 29	1/31	4/25	57.38 ± 9.44	55.90 ± 8.18	7

R: Retrospective cohort studies; RCT: Randomized controlled trial; M: Male; F: Female; TACE: Transarterial chemoembolization; LEN: Lenvatinib; SOR: Sorafenib; NA: Not available.

Table 2 Other basic characteristics and quality assessment of included studies

Ref.	Prior HBV infection, TACE + LEN1	Prior HBV infection, TACE + SOR1	ECOG-PS (0-1/2), TACE + LEN	ECOG-PS (0-1/2), TACE + SOR	Child-Pugh (A/B), TACE + LEN	Child-Pugh (A/B), TACE + SOR	Invading blood vessels, TACE + LEN1	Invading blood vessels, TACE + SOR1	Distant metastasis, TACE + LEN1	Distant metastasis, TACE + SOR1	AFP (< 400/≥ 400, ng/mL), TACE + LEN	AFP (< 400/≥ 400, ng/mL), TACE + SOR
Ding et al[15], 2021	30/2	29/3	24/7	22/10	22/10	28/4	32/0	32/0	19/13	23/9	16/16	14/18
Xue et al[16], 2021	46/4	97/3	37/13	84/16	41/9	84/16	36/14	81/19	27/23	45/55	NA	NA
Xu et al[17], 2023	38/5	36/5	20/23	23/18	32/11	28/13	17/26	15/26	11/32	12/29	23/20	26/15
Yang et al[18], 2021	36/2	34/4	27/11	27/11	37/1	37/1					14/24	15/23
Zhang et al[19], 2022	50/3	55/4	43/10	45/14	52/1	57/2	36/17	41/18	36/17	39/20	20/33	25/34
Zhao et al[20], 2022	22/1	21/11	12/11	18/14	19/4	27/5	10/13	18/14	1/22	22/10	NA	NA

¹No/Yes.

TACE: Transarterial chemoembolization; LEN: Lenvatinib; SOR: sorafenib; ECOG: Eastern Cooperative Oncology Group; AFP: Alpha fetoprotein; NA: Not available.

Table 3 Tumor response rate and long-term outcome

Measured outcomes	Studies, n	Heterogeneity test, I2 (%)	Heterogeneity test, P value	Model	RR/HR	95%CI	P value
Complete response	6	0	0.95	Random	1,81	1.11-2.96	0.02
Partial response	6	0	0.78	Random	1.38	1.12-1.70	0.002
Stable disease	6	50	0.08	Random	0.89	0.60-1.33	0.58
Progressive disease	6	0	0.67	Random	0.54	0.39-0.74	0.0002
Objective response rate	6	0	0.80	Random	1.47	1.24-1.74	< 0.0001
Disease control rate	6	82	< 0.0001	Random	1.22	1.00-1.49	0.05
Overall survival	4	39.8	0.173	Random	0.28	0.19-0.42	< 0.05
Disease free survival	4	0	0.482	Random	0.54	0.42-0.69	< 0.05

RR/HR: Relative risk /hazard ratio; CI: Confidence interval.

Table 4 Adverse events

Adverse events	Studies, n	Heterogeneity test, I2(%)	Heterogeneity test, P value	Model	RR	95%CI	P value
All adverse events	3	0	0.53	Random	0.97	0.79-1.20	0.80
Abdominal pain	4	0	0.68	Random	0.95	0.65-1.41	0.81
Fever	3	0	0.66	Random	0.95	0.72-1.25	0.69
Fatigue	4	0	0.68	Random	1.28	0.79-2.05	0.32
Nausea and vomiting	5	0	0.70	Random	1.25	0.85-1.83	0.25
Decreased appetite	5	0	0.76	Random	1.18	0.81-1.71	0.40
Liver dysfunction	4	0	0.46	Random	1.04	0.62-1.75	0.87
Hypertension	5	0	0.44	Random	2.53	1.19-5.39	0.02
Hand-foot skin reaction	5	75	0.003	Random	0.74	0.18-3.04	0.68
Diarrhea	6	39	0.16	Random	1.38	0.55-3.44	0.49
Thrombocytopenia	3	0	0.71	Random	1.18	0.71-1.98	0.52
Rash	6	65	0.04	Random	0.88	0.19-4.16	0.88

RR: Relative risk; CI: Confidence interval.