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Título
Risk versus Benefit of Tyrosine Kinase Inhibitors for Hepatocellular Carcinoma: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Autor
Facultad/Centro
Área de conocimiento
Título de la revista
Clinical Pharmacology & Therapeutics
Cita Bibliográfica
Payo-Serafín, T., Méndez-Blanco, C., Fernández-Palanca, P., Martínez-Geijo, J., Reviejo, M., Ortiz-de-Urbina, J.J., González-Gallego, J., Marin, J.J.G., Mauriz, J.L. and San-Miguel, B. (2024), Risk versus Benefit of Tyrosine Kinase Inhibitors for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Pharmacol Ther. https://doi.org/10.1002/cpt.3312
Editorial
Wiley
Fecha
2024
ISSN
0009-9236
Resumen
[EN]Although the treatment landscape has rapidly evolved over the last years, hepatocellular carcinoma (HCC) is one of the most lethal cancers. With recent advances, both immunotherapy and tyrosine kinase inhibitors (TKIs)-based chemotherapy constitute the standard treatment for advanced HCC. A systematic search of randomized clinical trials employing TKIs was performed in 17 databases, obtaining 25 studies evaluating the prognosis, tumor response, and presence of adverse events (AEs) related to TKIs in HCC. Overall effect sizes were estimated for the hazard ratios (HR) and odds ratios (OR) with 95% confidence interval (CI), either extracted or calculated with the Parmar method, employing STATA 16. Heterogeneity was assessed by Chi-square-based Q-test and inconsistency (I2) statistic; source of heterogeneity by meta-regression and subgroup analysis; and publication bias by funnel plot asymmetry and Egger's test. The research protocol was registered in PROSPERO (CRD42023397263). Meta-analysis revealed a correlation between survival and tumor response parameters and TKI treatment vs. placebo, despite detecting high heterogeneity. Combined TKI treatment showed a significantly better objective response rate (ORR) with no heterogeneity, whereas publication bias was only detected with time to progression (TTP). Few gastrointestinal and neurological disorders were associated with TKI treatment vs. placebo or with combined treatment. However, a higher number of serious AEs were related to TKI treatment vs. sorafenib alone. Results show positive clinical benefits from TKI treatment, supporting the approval and maintenance of TKI-based therapy for advanced HCC, while establishing appropriate strategies to maximize efficacy and minimize toxicity.
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SI
ID proyecto
- info:eu-repo/grantAgreement/Agencia Estatal de Investigación/Programa Estatal de I+D+i Orientada a los Retos de la Sociedad/PID2020-119164RB-I00/ES/GENERACION DE UN MODELO KNOCKOUT DE LOS FACTORES INDUCIBLES POR HIPOXIA PARA LA MEJORA DE LA SENSIBILIDAD A INHIBIDORES TIROSINA-QUINASA EN EL TRATAMIENTO DEL HEPATOCARCINOMA/PID2020-119164RB-I00
- info:eu-repo/grantAgreement/Instituto de Salud Carlos III/Programa Estatal de Generación de Conocimiento y Fortalecimiento del Sistema Español de I+D+I/PI19/00819/ES/INTERES PRONOSTICO Y TERAPEUTICO DE LAS PROTEINAS SLC Y ABC EN ADENOCARCINOMAS HEPATICOS Y GASTROINTESTINALES
- info:eu-repo/grantAgreement/Instituto de Salud Carlos III/Programa Estatal para Impulsar la Investigación Científico-Técnica y su Transferencia/PI22/00526/ES/RELACIÓN ENTRE EL SPLICING ABERRANTE Y LA MALIGNIDAD DEL CARCINOMA HEPATOCELULAR: BÚSQUEDA DE NUEVAS DIANAS TERAPÉUTICAS.
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