1
|
Li H, Wu Z, Chen J, Su K, Guo L, Xu K, Gu T, Jiang Y, Wang P, Zeng H, Chi H, He K, Han Y. External radiotherapy combined with sorafenib has better efficacy in unresectable hepatocellular carcinoma: a systematic review and meta-analysis. Clin Exp Med 2023; 23:1537-1549. [PMID: 36495367 PMCID: PMC10460724 DOI: 10.1007/s10238-022-00972-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
Advanced hepatocellular carcinoma (HCC) has a very low resectable rate. This meta-analysis aimed to compare efficacy of three combination strategies in treatment of advanced unresectable HCC with a view of guiding future selection of the best combination therapy for sorafenib and local therapy. A search was conducted to identify relevant literature published between April 2013 and May 2022, and then compared efficacy of sorafenib combined with external radiotherapy (SOF + RT), sorafenib with transarterial chemoembolization (SOF + TACE), sorafenib with hepatic artery infusion chemotherapy (SOF + HAIC), sorafenib (SOF), external radiotherapy (RT), transarterial chemoembolization (TACE), and hepatic artery infusion chemotherapy (HAIC) were studied and analyzed. Finally, the results were statistically analyzed using R 3.5.3 software and Stata/SE 15.0 software. A total of 46 studies, involving 7595 patients, were included in the meta-analysis. Analysis of overall survival (OS) and progression-free survival (PFS) of seven related treatment interventions revealed that the combination therapy had significantly higher efficacy than monotherapies. Among the combination therapies, SOF + RT was associated with the best OS and PFS rates, and the least adverse events compared to the other treatment modalities. The efficacy of combination therapy was better than monotherapy. In combination therapy, the overall survival time and progression-free survival time of SOF + RT were longer, and the adverse reactions were less. Therefore, SOF + RT may be the best choice for sorafenib combined with local therapy.
Collapse
Affiliation(s)
- Han Li
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Zhenying Wu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Jiali Chen
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Ke Su
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Lu Guo
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Ke Xu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Tao Gu
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Yi Jiang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Pan Wang
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Hao Zeng
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China
| | - Hao Chi
- Clinical Medical College, Southwest Medical University, Luzhou, 646000, China
| | - Kun He
- Clinical Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
| | - Yunwei Han
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, 646000, Sichuan Province, China.
| |
Collapse
|
2
|
You R, Xu Q, Wang Q, Zhang Q, Zhou W, Cao C, Huang X, Ji H, Lv P, Jiang H, Lu Y, Jin Y, Li Y, Cheng L, Wang W, Xu H, Zhu X, Yin G. Efficacy and safety of camrelizumab plus transarterial chemoembolization in intermediate to advanced hepatocellular carcinoma patients: A prospective, multi-center, real-world study. Front Oncol 2022; 12:816198. [PMID: 35982962 PMCID: PMC9378838 DOI: 10.3389/fonc.2022.816198] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/06/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Camrelizumab is a newly developed program-death receptor one inhibitor; the real-world evidence about its application in hepatocellular carcinoma (HCC) treatment is lacking. Therefore, this prospective, multi-center, real-world study evaluated the efficacy and safety of camrelizumab plus transarterial chemoembolization (TACE) in treating intermediate-to-advanced HCC patients. Methods This study consecutively enrolled 101 intermediate to advanced HCC patients. All patients received camrelizumab-based treatment within 30 days of the perioperative period of the TACE operation. The primary outcome was progression-free survival (PFS), and the secondary effects were overall survival (OS), objective response rate (ORR), disease control rate (DCR), and AEs. Results Specifically, the median PFS was 9.7 (95% confidence interval: 7.4–12.0) months, with a 1-year PFS rate of 30.6%. Meanwhile, the median OS was not reached (NR) yet, with a 1-year OS rate of 61.9%. Besides, the CR, PR, SD, and PD rates were 12.8%, 44.9%, 29.5%, and 12.8%, respectively. The ORR and DCR were 57.7% and 87.2%, respectively. More cycles of camrelizumab were independently correlated with prolonged PFS (hazard ratio (HR): 0.415, P = 0.002), whereas longer intervals between camrelizumab administration and TACE were independently associated with unfavorable PFS (HR: 1.873, P = 0.032). The incidence of total AEs was 90.1%; most AEs were grade 1 (20.8%), grade 2 (28.7%) and grade 3 (37.6%), while only 3 (3.0%) patients had grade 4 AEs. Conclusion The camrelizumab plus TACE regimen is effective and safe, indicating its potential to serve as a promising treatment choice for intermediate to advanced HCC patients.
Collapse
Affiliation(s)
- Ran You
- Interventional Radiology Department, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Qingyu Xu
- Interventional Radiology Department, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Qi Wang
- Interventional Radiology Department, The First People’s Hospital of Changzhou, Changzhou, China
| | - Qingqiao Zhang
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Weizhong Zhou
- Interventional Radiology Department, Jiangsu Province Hospital, Nanjing, China
| | - Chi Cao
- Interventional Radiology Department, Xuzhou Central Hospital, Xuzhou, China
| | - Xiangzhong Huang
- Interventional Radiology Department, Jiangyin People’s Hospital, Jiangyin, China
| | - Honghai Ji
- Interventional Radiology Department, Yancheng No. 1 People’s Hospital, Yancheng, China
| | - Penghua Lv
- Interventional Radiology Department, The Northern Jiangsu People’s Hospital, Yangzhou, China
| | - Hao Jiang
- Interventional Radiology Department, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - You Lu
- Interventional Radiology Department, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Jin
- Interventional Radiology Department, The Second Affiliated Hospital of SooChow University, Suzhou, China
| | - Yongjun Li
- Interventional Radiology Department, Nantong Tumor Hospital, Nantong, China
| | - Long Cheng
- Interventional Radiology Department, Xuzhou Central Hospital, Xuzhou, China
| | - Weidong Wang
- Interventional Radiology Department, Wuxi People’s Hospital, Wuxi, China
| | - Hao Xu
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- *Correspondence: Guowen Yin, ; Xiaoli Zhu, ; Hao Xu,
| | - Xiaoli Zhu
- Interventional Radiology Department, The First Affiliated Hospital of SooChow University, Suzhou, China
- *Correspondence: Guowen Yin, ; Xiaoli Zhu, ; Hao Xu,
| | - Guowen Yin
- Interventional Radiology Department, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Guowen Yin, ; Xiaoli Zhu, ; Hao Xu,
| |
Collapse
|
3
|
Zhu H, Zhou W, Wan Y, Lu J, Ge K, Jia C. Delivery of Adriamycin Loaded Niosomes for Liver Cancer Treatment. J Biomed Nanotechnol 2022. [DOI: 10.1166/jbn.2022.3390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The delivery efficiency of Adriamycin is crucial for the therapy of hepatocellular carcinoma. Niosome is a promising carrier that can be used for targeted drug delivery. However, the therapeutic effect of Adriamycin loaded niosome is still unclear. In this study, Adriamycin loaded niosomes
were constructed as a promising drug carrier system. The morphological determination of niosomes was conducted by transmission electron microscopy. Cell fluorescence was used for cellular uptake analysis. Western blotting was used to estimate the apoptosis-related protein expression in HepG2
cells. 3-(4,5)-di-methylthiahiazo(-z-y1)-3,5-di-phenytetrazolium bromide assay was used for estimating the apoptosis of cancer cells. The in vivo anti-cancer effect and safety of Adriamycin loaded niosomes were analyzed in tumor-bearing mice. Adriamycin loaded niosomes improved the
cellular uptake of Adriamycin. The anti-cancer effect of Adriamycin in vivo was enhanced. The responsive release of Adriamycin loaded niosomes under acidic conditions reduced the toxicity of Adriamycin to normal cells and the mortality of tumor-bearing mice. Together, Adriamycin loaded
niosomes improved its anti-cancer effect and safety for liver cancer treatment.
Collapse
Affiliation(s)
- Hanzhang Zhu
- Department of Hepatopancreatobiliary Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310006, Zhejiang, China
| | - Weijiang Zhou
- Department of Hepatopancreatobiliary Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310006, Zhejiang, China
| | - Yafeng Wan
- Department of Hepatopancreatobiliary Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310006, Zhejiang, China
| | - Jun Lu
- Department of Hepatopancreatobiliary Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310006, Zhejiang, China
| | - Ke Ge
- Department of Hepatopancreatobiliary Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310006, Zhejiang, China
| | - Changku Jia
- Department of Hepatopancreatobiliary Surgery, Hangzhou First People’s Hospital, The Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310006, Zhejiang, China
| |
Collapse
|