Evidence map›Paper›PMID 41653198›Full record

SynthesisCancer immunology, immunotherapy : CII2026

Comparative efficacy of combination regimens based on interventional therapy and immune checkpoint inhibitors (ICIs) in patients with intermediate- and advanced-stage hepatocellular carcinoma: a systematic review, meta-analysis, and network meta-analysis.

Jingting Su, Yuejiao Su, Rongyun Mai, Xing Gao, Shizhou Li, Dandan Zeng, Weijie Cen, Zhenbo Huang, Xiaoqing Li, Haoyu Zeng and 7 more

Abstract readSystematic ReviewNetwork Meta-AnalysisComparative Study
In one paragraph

Synthesis in Cancer immunology, immunotherapy : CII, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Article
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

17 authors.

Jingting Su *Department of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Yuejiao Su *Department of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Rongyun MaiDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Xing GaoDepartment of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Shizhou LiDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Dandan ZengDepartment of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Weijie CenDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Zhenbo HuangDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Xiaoqing LiDepartment of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Haoyu ZengDepartment of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Wenbing LiDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Can ZengDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Tianzhun WuDepartment of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Kaixiang MoDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China.
Jiazhou YeDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China. yejiazhou@gxmu.edu.cn.
Yan LinDepartment of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China. linyan@gxmu.edu.cn.
Rong LiangDepartment of Digestive Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530200, Guangxi, China. liangrong@gxmu.edu.cn.

Funding

Nanning Qingxiu District Science and Technology Project 2021007Nanning Qingxiu District Science and Technology Project 2021010Nanning Qingxiu District Science and Technology Project 2021012National Natural Science Foundation of China 82060427National Natural Science Foundation of China 82560610Natural Science Foundation of Guangxi Province 2024GXNSFAA010401Natural Science Foundation of Guangxi Province 2024GXNSFDA010046Natural Science Foundation of Guangxi Province 2025GXNSFBA069552Natural Science Foundation of Guangxi Province 2025GXNSFDA069007Project for Enhancing Young and Middle-aged Teacher's Research Basis Ability in Colleges of Guangxi 2024KY0133
6 · The paper itself

Abstract

backgroundCombining interventional therapy with immune checkpoint inhibitors (ICIs) has shown potential benefits in hepatocellular carcinoma (HCC). However, comprehensive evidence on its efficacy and safety remains limited.

methodsA systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify eligible studies for single-arm and Bayesian network meta-analyses (NMA). Progression-free survival (PFS) was the primary endpoint, while overall survival (OS), objective response rate (ORR), and grade ≥ 3 adverse events (AEs) were secondary outcomes (PROSPERO: CRD42024619661).

findingsThis study included 45 studies (n = 4,738), evaluating 14 distinct regimens. In single-arm analysis, transcatheter arterial chemoembolization (TACE) plus tyrosine-kinase inhibitor (TKI) plus tislelizumab [TACE-TKI-Tisle] yielded a pooled median PFS of 11.7 months (95% confidence interval [CI] 8.02-15.37), an ORR of 72% (95% CI 63-80%), and a grade ≥ 3 AE rate of 24% (95% CI 15-34%). NMA showed that TACE-TKI-Tisle and TACE-TKI-Camrelizumab (Camre) achieved significantly longer PFS than TACE-TKI or TACE alone. TACE-TKI-Toripalimab (Tori) showed OS benefits over TACE-TKI-Camre (HR = 0.43; 95% CI 0.20-0.95) and TACE-TKI-Pembrolizumab (Pembro) (HR = 0.32; 95% CI 0.13-0.81). Cumulative ranking via surface under the cumulative ranking curve (SUCRA) indicated that TACE-TKI-ICI achieved the highest efficacy ranking. TACE-TKI-Tisle and TACE-TKI-Tori ranked highest for PFS/ORR, with TACE-TKI-Tori ranking first for OS (SUCRA = 0.981). While TACE-TKI-ICI combinations were generally associated with more grade ≥ 3 AEs, TACE-TKI-Tisle ranked intermediately for safety (SUCRA = 0.426).

conclusionTACE-TKI-ICI combinations show promising efficacy in HCC. TACE-TKI-Tisle offers balanced efficacy and safety, while TACE-TKI-Tori provides notable OS benefits, warranting further validation in prospective studies.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, HepatocellularChemoembolization, TherapeuticImmune Checkpoint InhibitorsLiver NeoplasmsCombined Modality TherapyHumansNeoplasm StagingImmune Checkpoint InhibitorsHepatocellular carcinomaImmunotherapyMeta-analysisSurvival outcomesTransarterial interventional therapy

Identifiers

PMID41653198
PMCPMC12882918

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Registered trials

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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.