Chemotherapy

Anticancer Section / Review

Effectiveness and Safety of Combination Therapy of Transarterial Chemoembolization and Apatinib for Unresectable Hepatocellular Carcinoma in the Chinese Population: A Meta-Analysis

Wei Y.a,c · Liu J.c · Yan M.b · Zhao S.a · Long Y.b · Zhang W.b

Author affiliations

aDepartment of Gastroenterology, Tangdu Hospital of the Fourth Military Medical University, Xi’an, China
bDepartment of Epidemiology, School of Public Health, The Fourth Military Medical University, Xi’an, China
cDepartment of Outpatient, 986th Military Hospital, Xi’an, China

Keywords: ApatinibTransarterial chemoembolizationHepatocellular carcinomaMeta-analysisTherapy

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Chemotherapy 2019;64:94–104
https://doi.org/10.1159/000502510

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Article / Publication Details

First-Page Preview
Abstract of Anticancer Section / Review

Received: June 21, 2019
Accepted: August 05, 2019
Published online: September 30, 2019
Issue release date: October 2019

Number of Print Pages: 11
Number of Figures: 8
Number of Tables: 3

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: https://www.karger.com/CHE

Abstract

Background: The combination of transarterial chemoembolization (TACE) and apatinib has been used in the treatment of intermediate or advanced hepatocellular carcinoma (HCC). However, its effectiveness and safety are also argued. Methods: Eligible studies were collected from a computer search of literatures published from the database establishment to May 2019 in PubMed, Web of Science, EMBASE, Ovid, the Cochrane Library, Wanfang Database, China National Knowledge Infrastructure, and China Biology Medicine Disc. The objective response rate (ORR), the disease control rate (DCR), survival rate (SR), and the incidences of treatment-related adverse effects (AEs) were collected as the relevant outcomes. Data were analyzed through fixed/random effects of meta-analysis models with RevMan 5.3 software. Results: Eight randomized controlled clinical trials comprising 528 patients and 4 cohort studies comprising 226 patients were eventually included. Compared to the control group treated with TACE solely, combination therapy group, in which intermediate or advanced HCC patients were treated with TACE and apatinib, significantly enhanced ORR (relative risk [RR] 2.06, 95% CI 1.63–2.61, p < 0.001), DCR (RR 1.65, 95% CI 1.24–2.20, p < 0.001), and whole SRs of 6-month (RR 1.52, 95% CI 1.08–2.14, p = 0.02), 1-year (RR 1.52, 95% CI 1.25–1.84, p < 0.001), and 2-year (RR 1.84, 95% CI 1.34–2.54, p < 0.001). The incidence of hand foot syndrome, proteinuria, hypertension, and diarrhea was significantly increased in the combination therapy group compared with the control group (p < 0.05), and the incidence of nausea and vomiting, fever, and myelosuppression, respectively, was similar in 2 groups (p > 0.05). Conclusions: The combination therapy of TACE and apatinib can enhance the clinical effectiveness better than TACE solely in patients with intermediate or advanced HCC, while increase in the AEs is usually tolerable.

© 2019 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Anticancer Section / Review

Received: June 21, 2019
Accepted: August 05, 2019
Published online: September 30, 2019
Issue release date: October 2019

Number of Print Pages: 11
Number of Figures: 8
Number of Tables: 3

ISSN: 0009-3157 (Print)
eISSN: 1421-9794 (Online)

For additional information: https://www.karger.com/CHE

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2019, Vol.64, No. 2

October 2019

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S.Z., Y.L., and W.Z. contributed equally to this work.

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