SynthesisClinical cancer research : an official journal of the American Association for Cancer Research2022
Objective Response Predicts Survival in Advanced Hepatocellular Carcinoma Treated with Systemic Therapies.
Synthesis in Clinical cancer research : an official journal of the American Association for Cancer Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Response Rate Correlates with the Conversion Rate in Patients with Advanced Hepatocellular Carcinoma Treated with Systemic or Hepatic Artery Infusion Chemotherapy: A Systematic Review.Digestive surgery · 2026Pooled it
- Surrogacy of one-year survival for overall survival in advanced hepatocellular carcinoma.BMC cancer · 2024Pooled it
- Response evaluation to systemic therapy in HCC: Current challenges and future perspectives.Hepatology (Baltimore, Md.) · 2026Review
- Radiologic Response Assessment With RECIST 1.1 and mRECIST in Patients With Hepatocellular Carcinoma Treated With Atezolizumab Plus Bevacizumab.Korean journal of radiology · 2026Article
- Systematic evaluation and meta-analysis of the diagnostic accuracy of ultrasound contrast in predicting the efficacy of systemic therapy for advanced hepatocellular carcinoma.Translational cancer research · 2026Article
- Characterization of Patients with Unresectable Hepatocellular Carcinoma in REFLECT Who Achieved Tumor Response or Alpha-Fetoprotein Response When Treated with Lenvatinib.Liver cancer · 2026Article
- Integrating molecular and immune biomarkers for precision therapy in hepatitis B: Associated hepatocellular carcinoma.World journal of hepatology · 2026Article
- Efficacy analysis of icaritin combined with transarterial chemoembolization in hepatocellular carcinoma stratified by different child-pugh classes.Frontiers in immunology · 2026Article
- Long-term survival benefit of atezolizumab/bevacizumab treatment in unresectable HCC patients.Hepatology international · 2025Article
- Molecular biomarkers of sintilimab plus lenvatinib in hepatitis-B-virus-associated hepatocellular carcinoma.World journal of hepatology · 2025Article
- Depth of Response Predicts Survival in Unresectable Hepatocellular Carcinoma Treated with Immunotherapy: Not All Stable Disease Is Equal.Liver cancer · 2025Article
- Inter-reader agreement of RECIST and mRECIST criteria for assessing response to transarterial chemoembolization in hepatocellular carcinoma.BMC medical imaging · 2025Article
- Advancing the management of hepatocellular carcinoma: surrogate markers and predictive biomarkers for survival on immunotherapy.Hepatobiliary surgery and nutrition · 2025Article
- Systemic Therapy Combined with Locoregional Therapy in Intermediate-stage Hepatocellular Carcinoma.Interventional radiology (Higashimatsuyama-shi (Japan) · 2025Review
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- Article
- Review
- Characterization of Tumor Responses in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib in the Phase 3 Randomized Trial: REFLECT.Liver cancer · 2024Article
- Hepatocellular Carcinoma: The Evolving Role of Systemic Therapies as a Bridging Treatment to Liver Transplantation.Cancers · 2024Review
- Reclassification of therapeutic response of unresectable hepatocellular carcinoma to anti-angiogenic therapy and immunotherapy using alpha RECIST.European radiology · 2024Article
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 6 countries.
Funding
Abstract
purposeBecause of the increased number of sequential treatments used for advanced hepatocellular carcinoma (HCC), there is a need for surrogate endpoints of overall survival (OS). We analyze whether objective response (OR) is an independent predictor and surrogate endpoint of OS. PATIENTS AND
methodsA systematic review of randomized clinical trials (RCT) in advanced HCC published between 2010 and 2020 was conducted to explore OS surrogacy of OR by Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST). In parallel, RCTs exploring the impact of OR on OS in a time-dependent multivariate analysis were integrated in a meta-analysis.
resultsOf 65 RCTs identified in advanced HCC, we analyzed 34 studies including 14,056 patients that reported OS and OR by either RECIST (n = 23), mRECIST (n = 5), or both (n = 6). When exploring surrogacy, the trial-level correlation between OR odds ratio and OS HR was R = 0.677 by mRECIST and R = 0.532 by RECIST. Meta-analysis of five RCTs assessing predictors of survival in multivariate analysis found that patients with OR by mRECIST presented a pooled HR for OS of 0.44 (95% confidence interval, 0.27-0.70; P < 0.001) compared with nonresponders. Responses to atezolizumab-bevacizumab had a greater impact on OS than tyrosine kinase inhibitor responses.
conclusionsOR-mRECIST is an independent predictor of OS in patients with advanced HCC. Although correlation of OR-mRECIST and OS is better than with OR-RECIST, the level of surrogacy is modest. Thus, it can be used as endpoint in proof-of-concept phase II trials, but the data do not support its use as a primary endpoint of phase III investigations assessing systemic therapies.
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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.