Evidence map›Paper›PMID 37844117›Full record

SynthesisPloS one2023

Triple combination of HAIC-FO plus tyrosine kinase inhibitors and immune checkpoint inhibitors for advanced hepatocellular carcinoma: A systematic review and meta-analysis.

Zhongbao Tan, Jian Zhang, Lan Xu, Huanjing Wang, Xuequn Mao, Rong Zou, Qingqing Wang, Zhuang Han, Zhenhai Di, Daguang Wu

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 16% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Zhongbao TanDepartment of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.ORCID 0000-0001-5739-9233
Jian ZhangDepartment of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.
Lan XuDepartment of Oncology, Funing County People's Hospital, Yancheng, Jiangsu Province, China.ORCID 0009-0000-4470-7989
Huanjing WangDepartment of ICU, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.
Xuequn MaoDepartment of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.
Rong ZouDepartment of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.
Qingqing WangDepartment of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.
Zhuang HanDepartment of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.
Zhenhai DiDepartment of Interventional Radiology, The Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, Jiangsu, China.
Daguang WuDepartment of Oncology, Funing County People's Hospital, Yancheng, Jiangsu Province, China.
Jiangsu University · CNJingning County People's Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe triple combination of hepatic arterial infusion chemotherapy (HAIC) with fluorouracil, leucovorin, and oxaliplatin (FOLFOX) plus tyrosine kinase inhibitor (TKI) and immune checkpoint inhibitors (ICIs) is expected to have a synergistic anticancer effect in HCC. We conducted this meta-analysis to evaluate the efficacy and safety of the triple combination treatment in advanced HCC patients.

methodsPubMed, Embase, Cochrane Library, Web of Science databases were systematically searched for relevant studies from the inception of each database to May 10, 2023. All articles focusing the triple combination treatment of HAIC-FO plus TKI and ICIs for advanced HCC were eligible. The meta-analysis was conducted following the PRISMA guidelines. The risk of bias was assessed using the Joanna Briggs Institute (JBI) for case series and Newcastle-Ottawa Scale (NOS) for cohort studies. The primary outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR). The secondary results were adverse events. Further meta-analysis of control studies demonstrated the superiority of the triple combination modality to TKI plus ICIs, and TKI alone.

resultsNine articles (four cohort studies and five one-arm studies) involving 777 advanced HCC patients were included in this meta-analysis. In terms of survival analysis, the pooled median PFS was 11 months (95% CI: 10.1-12.0 months) with low heterogeneity (I2 = 0%, p = 0.97). With regard to tumor response, the pooled ORR and DCR was 61.6% (I2=0%, p = 0.71) and 87.9% (I2 = 13%, p = 0.33) with low heterogeneity, respectively. As compared with TKIs plus ICIs, and TKIs alone, the triple combination thrapy was associated with improved median OS (HR=0.51, 95%CI 0.41-0.62) with low heterogeneity across studies (I2 = 0%, p = 0.47), median PFS (HR=0.51, 95%CI 0.41-0.64) with low heterogeneity across studies (I2 = 0%, p = 0.41), ORR (RR = 0.56, 95% CI: 0.42-0.74) with high heterogeneity across studies (I2 = 69%, p = 0.02), and DCR (RR = 0.38, 95%CI 0.27-0.54) with low heterogeneity across studies (I2 = 14%, p = 0.32). The most common 3/4 AEs were elevated ALT and AST, thrombocytopenia, hypertension, nausea and vomiting in this meta-analysis.

conclusionsThe triple combination therapy of HAIC-FO plus TKI and ICIs showed promising efficacy and safety in patients with advanced HCC. REGISTRATION: The protocol was registered with PROSPERO (ID:CRD42023424281).

Indexed as

Antineoplastic AgentsCarcinoma, HepatocellularLiver NeoplasmsHumansImmune Checkpoint InhibitorsProtein Kinase InhibitorsTyrosine Kinase InhibitorsAntineoplastic AgentsImmune Checkpoint InhibitorsProtein Kinase InhibitorsTyrosine Kinase Inhibitors

Identifiers

PMID37844117
PMCPMC10578571
OpenAlexW4387666168

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.