ReviewFrontiers in pharmacology2026
Efficacy and safety of tyrosine kinase inhibitors in advanced hepatocellular carcinoma patients with Child-Pugh A and B cirrhosis: a meta-analysis.
Review in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: Hepatocellular carcinoma (HCC) remains a leading cause of cancer mortality. Tyrosine kinase inhibitors (TKIs) are widely used in advanced HCC, yet outcomes may differ by hepatic reserve. We compared the efficacy and safety of guideline-recommended TKIs between patients with Child-Pugh A (CP-A) and Child-Pugh B (CP-B) cirrhosis. Methods: We conducted a PRISMA-guided systematic review and meta-analysis (searches through 15 October 2024). Eligible studies evaluated TKI monotherapy and reported outcomes separately for CP-A and CP-B. Primary endpoints were overall response rate (ORR), disease control rate (DCR), and grade ≥3 treatment-related adverse events (trAEs). Pooled risk ratios (RRs) with 95% CIs were estimated using prespecified random-effects models; small-study effects were explored with funnel plots (and Egger's test when k ≥ 10). Results: Twenty-four studies met inclusion. Pooled analyses showed no significant differences between CP-B and CP-A for ORR (k ≈ 15; RR 1.02, 95% CI 0.83-1.27; I Conclusion: In advanced HCC treated with TKI monotherapy, radiologic efficacy (ORR, DCR) appears broadly comparable between CP-B and CP-A, whereas CP-B may experience higher rates of grade ≥3 toxicities. TKIs remain a reasonable option for selected CP-B patients, provided dosing is individualized and adverse events are closely monitored. Prospective, stratified studies are needed to refine patient selection and dose management in CP-B.
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