SynthesisFrontiers in immunology2026
Comparative efficacy and safety of first-line treatments for advanced hepatocellular carcinoma: a Bayesian network meta-analysis.
Synthesis in Frontiers in immunology, 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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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.
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9 authors.
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Abstract
Background: The therapeutic landscape of advanced hepatocellular carcinoma (HCC) has expanded beyond sorafenib, with multiple combination regimens now demonstrating improved outcomes. However, the absence of direct head-to-head comparisons complicates treatment selection in clinical practice. Methods: We performed a Bayesian network meta-analysis of phase III randomized controlled trials to compare the efficacy and safety of first-line treatments for patients with advanced HCC. Overall survival (OS), progression-free survival (PFS), and grade ≥ 3 adverse events were assessed. Treatment rankings were estimated using surface under the cumulative ranking curve values. Results: Sixteen trials comprising 8, 753 patients were included. Hepatic arterial infusion chemotherapy (HAIC)-based regimens, particularly sorafenib plus HAIC and HAIC_FO, achieved the highest rankings for both PFS and OS. Several immunotherapy-based combinations also demonstrated significant survival benefits across multiple clinical subgroups without a corresponding increase in severe adverse events. Subgroup analyses suggested consistent benefits of selected regimens across age, sex, macrovascular invasion, extrahepatic spread, and ECOG performance status. Conclusions: HAIC-based strategies and selected immunotherapy combinations appear to provide superior survival outcomes as first-line treatment for advanced HCC. Given limitations related to comparator selection and evolving evidence, future head-to-head randomized trials and updated network analyses are warranted to refine optimal treatment strategies. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251124082.
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