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SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1502931
Comparison of efficacy and safety of adjuvant therapies versus sorafenib in hepatocellular carcinoma: A systematic review and network meta-analysis
Provisionally accepted- 1 Universiti Sains Malaysia Health Campus, Kota Bharu, Kelantan, Malaysia
- 2 Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kota Bharu, Malaysia
Purpose: Diverse novel therapeutic options for hepatocellular carcinoma (HCC) have surfaced in recent years. However, it is increasingly difficult to select the optimal medication. This research aims to assess overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), adverse events (AEs), and severe adverse events (SAEs) in HCC patients receiving adjuvant therapies compared to those receiving sorafenib.Methods: Four databases were used to search articles. Only randomized controlled trials were included. Indicators such as OS, PFS, DCR, ORR, AEs and SAEs were used as outcomes. The protocol for this meta-analysis was registered with PROSPERO (Registration ID: CRD42024544394).Results: Forty trials were included in this meta-analysis. The Oxaliplatin, Fluorouracil, and Leucovorin (OFL) + sorafenib group and the sintilimab + bevacizumab biosimilar group decreased the risk of death and increased PFS, ORR, and DCR. Yet, they also yielded remarkable adverse effects and severe adverse effects. To sum up, the atezolizumab + bevacizumab combination and tepotinib were recommended due to their favorable performance on all indexes.Conclusion: This study further substantiates the efficacy of combination therapies in HCC, while they cause more toxicity in general. It is pressingly urgent to develop new drugs for liver cancer and find rational strategies to alleviate AEs.
Keywords: Hepatocellular Carcinoma, Sorafenib, adjuvant therapy, Meta-analysis, Systematic review
Received: 27 Sep 2024; Accepted: 14 Feb 2025.
Copyright: © 2025 Quan, Zulkifli, Binti Saari, Shueb and Mustaffa. 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:
Nazri Mustaffa, Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kota Bharu, Malaysia
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.