Lenvatinib versus sorafenib as first-line therapy of advanced hepatocellular carcinoma: A systematic review and meta-analysis

Antonio Facciorusso, Nicola Tartaglia, Rosanna Villani, Gaetano Serviddio, Daryl Ramai, Babu P. Mohan, Saurabh Chandan, Mohamed A.Abd El Aziz, Jessica Evangelista, Christian Cotsoglou, Antonio Ambrosi

Research output: Contribution to journalArticlepeer-review

Abstract

There is limited evidence on the efficacy of lenvatinib in advanced hepatocellular carcinoma (HCC) patients. Aim of this meta-analysis was to compare lenvatinib and sorafenib as first-line treatment. Computerized bibliographic search was performed on main databases through November 2020. The primary outcome was overall survival, whereas survival rate (at 1-, and 2-year), progression-free survival (PFS), tumor response, and severe adverse event rate were the secondary outcomes. Results were expressed in terms of odds ratio (OR) or hazard ratio (HR) and 95% confidence interval (CI). Five studies enrolling 1481 patients were included. No difference in terms of overall survival was detected (HR 0.81, 0.58-1.11) and median survival was 13.4 months (9.38-17.48) in lenvatinib and 11.4 months (8.46-14.47) in sorafenib patients. Lenvatinib led to a significant improvement of PFS (HR 0.67, 0.48-0.94) and median PFS was 5.88 months (3.68-8) in lenvatinib and 4.17 months (3.08-5.25) in sorafenib patients. Lenvatinib determined a considerably higher rate of objective response (33.3%, 23.6%-43% versus 6.5%, 3.5%-9.5%; OR 7.70, 2.99-19.82), and of disease control rate (76.9%, 70.4%-83.5% versus 52.7%, 40.7%-64.6%; OR 2.41, 1.55-3.77). No difference between lenvatinib and sorafenib in terms of severe adverse event rate was observed (OR 1.31, 0.82-2.09). Lenvatinib prolongs progression-free survival as compared to sorafenib in HCC patients, although this result does not translate to a significant survival benefit.

Original languageEnglish (US)
Pages (from-to)2379-2387
Number of pages9
JournalAmerican Journal of Translational Research
Volume13
Issue number4
StatePublished - 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Molecular Medicine
  • Clinical Biochemistry
  • Cancer Research

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