Comparing the effectiveness and safety of Sorafenib plus TACE with Apatinib plus TACE for treating patients with unresectable hepatocellular carcinoma: a multicentre propensity score matching study

Yin, Liang; Liu, Kai‐Cai; Lv, Wei‐Fu; Dong, Lü; Tan, Yulin; Wang, Guoxiang; Dai, Jianli; Zhu, Xianhai; Jiang, Bo

doi:10.1186/s40644-023-00574-7

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…A total of 215 articles were retrieved, and 73 repeated articles were excluded by title, year of publication, and author information. Then after reading abstracts and full-text screening, 130 articles that did not meet the criteria were excluded and finally included 12 studies [10,11,15–24] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…1). Of these, 5 studies [15,16,19,22,23] compared apatinib alone with sorafenib alone, and the other 7 studies [10,11,17,18,20,21,24] were apatinib plus TACE versus sorafenib plus TACE. A total of 1150 patients with advanced HCC were enrolled.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies [10,11,15–18] provided OS data, of which 2 studies [15,16] were apatinib alone vs sorafenib alone, and the other 4 studies [10,11,17,18] were apatinib plus TACE vs sorafenib plus TACE. Based on the heterogeneity test results (A vs S: P = .70, I2 = 0%; A + T vs S + T: P = .70, I2 = 0%).…”

Section: Resultsmentioning

confidence: 99%

“…[35] In the setting of combined TACE treatment, apatinib and sorafenib can benefit patients with advanced HCC, but their efficacy and safety are still controversial in clinical studies directly comparing apatinib plus TACE and sorafenib plus TACE. [10,11] Based on this, we conducted a comprehensive literature search (up to August 14, 2023) to evaluate the efficacy and safety of a new TKI (apatinib) versus a traditional TKI (sorafenib) in the first-line treatment of advanced HCC, including evaluating the differences in efficacy and safety of these 2 TKIs in the setting of combined TACE treatment, so as to provide evidence for clinical rational drug use.…”

Section: Discussionmentioning

confidence: 99%

“…[8,9] In recent years, conclusions regarding the efficacy and safety of apatinib and sorafenib as first-line treatment for advanced HCC in direct comparative studies are still controversial. [10,11] Therefore, this meta-analysis aims to evaluate the efficacy and safety of a new TKI (apatinib) versus a traditional TKI (sorafenib) in the first-line treatment of advanced HCC, including the efficacy and safety differences between these 2 TKIs when combined with TACE, to provide evidence for clinical rational drug use.…”

Section: Introductionmentioning

confidence: 99%

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The long-term efficacy and safety of apatinib are inferior to sorafenib in the first-line treatment of advanced hepatocellular carcinoma: A systematic review and meta-analysis

Li,

Zhang,

Yang

et al. 2024

Medicine

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Background: Apatinib, a novel tyrosine kinase inhibitor independently developed by China, has been widely used in the treatment of advanced hepatocellular carcinoma (HCC) in recent years. For more than a decade, sorafenib has been the classic first-line treatment option for patients with advanced HCC. However, the results of clinical studies comparing the efficacy and safety of these 2 drugs are still controversial. Therefore, the aim of this meta-analysis is to evaluate the efficacy and safety of apatinib versus sorafenib as first-line treatment for advanced HCC. Methods: Up to August 14, 2023, the databases of PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure, and Wanfang were searched, and clinical studies of experimental group (apatinib or apatinib plus transarterial chemoembolization [TACE]) versus control group (sorafenib or sorafenib plus TACE) in the first-line treatment of advanced HCC were included. Two researchers evaluated the quality of the included studies and extracted the data. Revman 5.4 software was used for meta-analysis. Results: A total of 12 studies involving 1150 patients were included. Five studies are apatinib alone versus sorafenib alone, and the other 7 studies are apatinib plus TACE versus sorafenib plus TACE. The results of the meta-analysis showed that compared with sorafenib alone, apatinib could improve (OR = 3.06, 95%CI: 1.76–5.31), had no advantage in improving DCR (OR = 1.52, 95%CI: 0.86–2.68) and prolonging PFS (HR = 1.35, 95%CI: 0.94–1.96), and was significantly worse in prolonging OS (HR = 1.43, 95%CI: 1.08–1.88). Similarly, apatinib plus TACE was inferior to sorafenib plus TACE in prolonging OS (HR = 1.15, 95%CI: 1.03–1.28), although it improved ORR (OR = 1.49, 95%CI: 1.03–2.16). In terms of adverse drug events, the overall incidence of adverse events, and the incidence of drug reduction and discontinuation in the experimental group were significantly higher than those in the control group (P < .05). The incidence of hypertension, proteinuria, and oral mucositis in the experimental group was significantly higher than that in the control group (P < .05). Conclusion: In the setting of first-line treatment of advanced HCC, apatinib has improved short-term efficacy (ORR) compared with sorafenib, but the safety and long-term efficacy of apatinib are inferior to sorafenib.

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Section: Resultsmentioning

confidence: 99%