SynthesisWorld journal of surgical oncology2025
Comparative efficacy and safety of transarterial chemoembolization combined with tyrosine kinase inhibitors and immune checkpoint inhibitors versus tyrosine kinase inhibitors and immune checkpoint inhibitors alone in advanced hepatocellular carcinoma: a systematic review and meta-analysis.
Synthesis in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Locoregional therapy combined with targeted therapy and immunotherapy for hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Survival in patients with unresectable hepatocellular carcinoma: TCC cocktail plus TACE vs TACE alone prospective randomized clinical trial.Journal of translational medicine · 2025Trial
- Sorafenib Combined with Tislelizumab and Transarterial Chemoembolization for Advanced-Stage Hepatocellular Carcinoma: A Phase II Study.ImmunoTargets and therapy · 2025Trial
- Inflammasome-associated pyroptosis and tumor angiogenesis in prostate cancer.Iranian journal of basic medical sciences · 2026Review
- Nivolumab Plus Lenvatinib and Intra-Arterial Locoregional Therapy as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Real-World Study.Journal of hepatocellular carcinoma · 2026Article
- Stage-Dependent Efficacy of TACE Combined with Tyrosine Kinase and Immune Checkpoint Inhibitors as Conversion Therapy for Unresectable Hepatocellular Carcinoma: A Multicenter Retrospective Study.Journal of hepatocellular carcinoma · 2026Article
- A novel clinical FIT model predicts prognosis of unresectable hepatocellular carcinoma treated with TACE combined with lenvatinib and PD-1 inhibitors therapy.Frontiers in immunology · 2026Article
- Prognostic analysis of different postoperative adjuvant therapies for patients with hepatocellular carcinoma after radical resection with high-risk recurrence factors: a multicenter real-world retrospective study.Frontiers in immunology · 2025Article
- The PLANES model for unresectable hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus lenvatinib and PD-1 inhibitors: a multicenter, retrospective study.Frontiers in immunology · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, and advanced-stage disease presents significant therapeutic challenges. Combining transarterial chemoembolization (TACE) with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) has emerged as a promising strategy to enhance treatment efficacy. This meta-analysis evaluates efficacy and safety of TACE + TKIs + ICIs compared to TKIs + ICIs alone in patients with HCC.
methodsA systematic search was conducted across "PubMed", "Web of Science", "Cochrane Library", "Scopus", "Google Scholar", and "Embase" to screen studies up to November 2024. Studies comparing TACE + TKIs + ICIs with TKIs + ICIs alone in advanced HCC were included. Outcomes of interest included objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS), and adverse events. Results were reported as relative risk (RR) or hazard ratios (HR) with 95% confidence intervals (CI). Funnel plots was used to assess publication bias.
resultsTen studies comprising 1999 patients were included. The combination of TACE + TKIs + ICIs marked improved ORR (RR = 1.81, 95%CI:1.57-2.09, P < 0.00001) and DCR (RR = 1.32, 95%CI: 1.19-1.46, P < 0.00001) comparing with TKIs + ICIs alone. OS and PFS were also significantly prolonged in combination group, with HR of 0.55 (95%CI:0.48-0.63, P < 0.00001) and 0.73 (95%CI:0.65-0.82, P < 0.00001), respectively. Adverse events such as pain (RR = 3.94, 95%CI:2.40-6.47, P < 0.001) and nausea/vomiting (RR = 2.28, 95% CI:1.56-3.33, P < 0.001) were more frequent in the TACE + TKIs + ICIs group, though rates of hypertension, diarrhea, and rash were similar between groups. Funnel plots indicated minimal publication bias for primary outcomes.
conclusionsThe combination of TACE, TKIs, and ICIs significantly improves ORR, DCR, OS, and PFS compared to TKIs and ICIs alone, demonstrating superior efficacy with an acceptable safety profile. These findings provide evidence for the integration of TACE with systemic therapies in the management of HCC.
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