Evidence map›Paper›PMID 34126063›Full record

SynthesisGastroenterology2021

Evidence-Based Management of Hepatocellular Carcinoma: Systematic Review and Meta-analysis of Randomized Controlled Trials (2002-2020).

Philipp K Haber, Marc Puigvehí, Florian Castet, Vennis Lourdusamy, Robert Montal, Parissa Tabrizian, Michael Buckstein, Edward Kim, Augusto Villanueva, Myron Schwartz and 1 more

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05859945 (A Critical Analysis of Hepatocellular Carcinoma Trials), which is not on this map. Cited by 166 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
166citing papers in PubMed, 7 pooled it
20.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05859945 unknown statusnot on this mapstarted 2024, after this paper: background citation

A Critical Analysis of Hepatocellular Carcinoma Trials: Perspectives From Patient Experiences

TypeobservationalSponsorPower Life Sciences Inc.Ran2024 to 2026Enrolled500ConditionsHepatocellular Carcinoma
3 · Its place in the literature

Who cites it

166 citing papers in PubMed, 7 syntheses or guidelines pooled it, 233 citations in OpenAlex.

  1. Pooled it
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  4. Guideline
  5. Pooled it
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  7. Objective Response Predicts Survival in Advanced Hepatocellular Carcinoma Treated with Systemic Therapies.Clinical cancer research : an official journal of the American Association for Cancer Research · 2022
    Pooled it
  8. Trial
  9. Article
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  13. Review
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106 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Philipp K HaberMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Marc PuigvehíMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Hepatology Section, Gastroenterology Department, Parc de Salut Mar, Hospital del Mar Medical Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
Florian CastetTranslational Research in Hepatic Oncology, Liver Unit, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Hospital Clinic, University of Barcelona, Catalonia, Spain.
Vennis LourdusamyMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Robert MontalCancer Biomarkers Research Group, Department of Medical Oncology, Hospital Universitari Arnau de Vilanova-IRBLleida, Lleida, Catalonia, Spain.
Parissa TabrizianMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Michael BucksteinMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Edward KimMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Augusto VillanuevaMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Myron SchwartzMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Josep M LlovetMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Translational Research in Hepatic Oncology, Liver Unit, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Hospital Clinic, University of Barcelona, Catalonia, Spain; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Catalonia, Spain. Electronic address: josep.llovet@mssm.edu.
Icahn School of Medicine at Mount Sinai · USHospital Universitari Arnau de Vilanova · ESInstitució Catalana de Recerca i Estudis Avançats · ESUniversitat Autònoma de Barcelona · ESUniversitat de Barcelona · ES

Funding

THE TISCH CANCER INSTITUTE - CANCER CENTER SUPPORT GRANTP30CA196521 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Ramon E Parsons · 2015 to 2026
$35.4M
Hepatic stellate cells in NASH fibrosis and HCCR01DK128289 · NIDDK · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI SCOTT L. FRIEDMAN · 2021 to 2026
$2.6M
Cancer Research UK 26813NCI NIH HHS P30 CA196521NIDDK NIH HHS R01 DK128289
6 · The paper itself

Abstract

BACKGROUND &

aimsHepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with a rapidly changing landscape of treatments. In the past 20 years, numerous randomized controlled trials (RCTs) have aimed at improving outcomes across disease stages. We aimed to analyze the current evidence and identify potential factors influencing response to therapies.

methodsWe conducted a systematic review of phase III RCTs (2002-2020) across disease stages. A meta-analysis was designed to examine the relationship between etiology and outcome after systemic therapies with either tyrosine-kinase inhibitor (TKI)/antiangiogenic or immune checkpoint inhibitor (ICI) therapy.

resultsOut of 10,100 studies identified, 76 were phase III RCTs. Among them, a rigorous screening algorithm identified 49 with high quality including a total of 22,113 patients undergoing adjuvant (n = 7) and primary treatment for early (n = 2), intermediate (n = 7), and advanced (first-line, n = 21; second-line, n = 12) stages of disease. Nine of these trials were positive, 6 treatments have been adopted in guidelines (sorafenib [2 RCTs], lenvatinib, atezolizumab+bevacizumab, regorafenib, cabozantinib and ramucirumab), but 2 were not (adjuvant CIK cells and sorafenib plus hepatic arterial infusion with FOLFOX). Meta-analysis of 8 trials including 3739 patients revealed ICI therapy to be significantly more effective in patients with viral hepatitis compared with nonviral-related HCC, whereas no differences related to etiology were observed in patients treated with TKI/anti-vascular endothelial growth factor.

conclusionsAmong 49 high-quality RCTs conducted in HCC during 2002-2020, 9 resulted in positive results. A meta-analysis of systemic therapies suggests that immunotherapies may be more effective in viral etiologies.

Indexed as

Ablation TechniquesChemoembolization, TherapeuticImmunotherapyAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, HepatocellularChemotherapy, AdjuvantClinical Trials, Phase III as TopicDisease ProgressionEvidence-Based MedicineHumansImmune Checkpoint InhibitorsLiver NeoplasmsNeoadjuvant TherapyNeoplasm StagingProgression-Free SurvivalRadiopharmaceuticalsImmune Checkpoint InhibitorsRadiopharmaceuticalsHepatocellular carcinomaLiver cancerRandomized controlled trialsSystematic review

Identifiers

PMID34126063
PMCPMC12276942
OpenAlexW3169705253

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.