TY - JOUR
T1 - Lenvatinib versus sorafenib as first-line therapy of advanced hepatocellular carcinoma
T2 - A systematic review and meta-analysis
AU - Facciorusso, Antonio
AU - Tartaglia, Nicola
AU - Villani, Rosanna
AU - Serviddio, Gaetano
AU - Ramai, Daryl
AU - Mohan, Babu P.
AU - Chandan, Saurabh
AU - El Aziz, Mohamed A.Abd
AU - Evangelista, Jessica
AU - Cotsoglou, Christian
AU - Ambrosi, Antonio
N1 - Publisher Copyright:
© 2021 E-Century Publishing Corporation. All rights reserved.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
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M3 - Article
AN - SCOPUS:85105306634
VL - 13
SP - 2379
EP - 2387
JO - American Journal of Translational Research
JF - American Journal of Translational Research
SN - 1943-8141
IS - 4
ER -