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REVIEW article

Front. Med.
Sec. Hepatobiliary Diseases
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1511511
This article is part of the Research Topic Hepatocellular Carcinoma: From Diagnostic Approaches to Surgical and Systemic Therapies View all 15 articles

Meta-analysis of the efficiency and safety of neoadjuvant therapy with immune checkpoint inhibitors in resectable hepatocellular carcinoma

Provisionally accepted
Adili Tuersun Adili Tuersun 1,2Munire Mohetaer Munire Mohetaer 1Guanxin Hou Guanxin Hou 2Gang Cheng Gang Cheng 1*
  • 1 Shenyang Pharmaceutical University, Shenyang, China
  • 2 Northern Theater Command General Hospital, Shenyang, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Purpose: Immunotherapy as a neoadjuvant treatment approach has achieved certain therapeutic effects in various types of cancer. However, in the specific cancer type of hepatocellular carcinoma (HCC), standardized protocols for neoadjuvant immunotherapy remain to be defined. This systematic review and meta-analysis focus on evaluating the efficacy and safety of neoadjuvant immunotherapy in the treatment of HCC, aiming to provide a robust basis for clinical decision-making.Methods: This study systematically searched databases such as PubMed, EMBASE, the Cochrane Library, and conference proceedings to identify clinical trials focusing on patients with HCC undergoing neoadjuvant immunotherapy. The Review Manager 5.4 software was applied to estimate the odds ratio (OR) of effect sizes and their corresponding 95% confidence intervals (CI).Results: Immune checkpoint inhibitors (ICIs) demonstrate significant efficacy in improving pathological outcomes and safety profiles in patients with resectable hepatocellular carcinoma (HCC). Specifically, ICIs significantly increase the pathological complete response (pCR) rate (OR=0.23, 95% CI [0.14, 0.37], P<0.00001) and major pathological response (MPR) rate (OR=0.47, 95% CI [0.32, 0.70], P=0.0002). They also markedly enhance the objective response rate (ORR) (OR=0.42, 95% CI [0.28, 0.63], P<0.0001). Furthermore, ICIs potentially improve the surgical resection rate (OR=3.91, 95% CI [2.05, 7.45], P<0.0001) and reduce the incidence of grade 3-4 treatment-related adverse events (TRAEs) (OR=0.27, 95% CI [0.17, 0.44], P<0.00001), indicating both therapeutic benefits and acceptable toxicity profiles.Neoadjuvant immunotherapy shows promise in the treatment of resectable HCC.Nonetheless, to further validate its efficacy, more large-scale, well-designed clinical trials are necessary to provide conclusive evidence.

    Keywords: neoadjuvant immunotherapy, Hepatocellular Carcinoma, Meta-analysis, Safety, Efficiency

    Received: 15 Oct 2024; Accepted: 20 Dec 2024.

    Copyright: © 2024 Tuersun, Mohetaer, Hou and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gang Cheng, Shenyang Pharmaceutical University, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.