Xu M, Zhou SR, Li YL, Zhang CH, Liao DZ, Wang XL. Efficacy of sorafenib combined with transarterial chemoembolization in the treatment of advanced hepatocellular carcinoma: A meta-analysis. World J Gastrointest Oncol 2025; 17(2): 98927 [PMID: PMC11756001 DOI: 10.4251/wjgo.v17.i2.98927]
Corresponding Author of This Article
Xiao-Li Wang, MD, Doctor, Department of Oncology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, No. 182 Chunhui Road, Luzhou 646000, Sichuan Province, China. wxl0427easy@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Feb 15, 2025; 17(2): 98927 Published online Feb 15, 2025. doi: 10.4251/wjgo.v17.i2.98927
Efficacy of sorafenib combined with transarterial chemoembolization in the treatment of advanced hepatocellular carcinoma: A meta-analysis
Mei Xu, Si-Rui Zhou, Ya-Ling Li, Chen-Hao Zhang, Da-Zhong Liao, Xiao-Li Wang
Mei Xu, Si-Rui Zhou, Da-Zhong Liao, Xiao-Li Wang, Department of Oncology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, Sichuan Province, China
Ya-Ling Li, Department of Pharmacy, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Chen-Hao Zhang, Department of Breast and Thyroid Surgery, The First People's Hospital of Yibin, Yibin 644000, Sichuan Province, China
Co-corresponding authors: Da-Zhong Liao and Xiao-Li Wang.
Author contributions: Xu M initiated the study and was instrumental in its conception. Both Xu M and Zhou SR played significant roles in conducting the literature review, data extraction, quality assessment, data analysis, and manuscript drafting; Xu M and Li YL made substantial contributions to enhancing the manuscript through improvements in language and style, as well as protocol development; Xu M and Zhang CH actively participated in data analysis and facilitated critical discussions that enriched the research. Liao DZ and Wang XL meticulously reviewed the final manuscript, providing their endorsement for publication. Both authors, Liao DZ and Wang XL are from the same hospital institution and have jointly guided and supervised the entire research project. They have also been responsible for arranging the division of labor and coordinating the collaboration between all team members. Additionally, they have actively monitored the progress and processes of the research. Their collaborative efforts in the design and execution of the study, as well as their significant contributions to the manuscript, have been essential. Given their equal involvement and leadership throughout the research process, we have designated them as co-corresponding authors. This designation reflects their shared responsibility for both the project and the manuscript and ensures that the communication responsibilities are appropriately represented by both individuals.
Supported by Sichuan Science and Technology Program, No. 2022YFS0625.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Li Wang, MD, Doctor, Department of Oncology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, No. 182 Chunhui Road, Luzhou 646000, Sichuan Province, China. wxl0427easy@163.com
Received: July 9, 2024 Revised: November 22, 2024 Accepted: December 10, 2024 Published online: February 15, 2025 Processing time: 192 Days and 22.1 Hours
Abstract
BACKGROUND
The combination of sorafenib with transarterial chemoembolization (TACE) is being investigated for its potential to improve outcomes in advanced hepatocellular carcinoma (HCC).
AIM
To evaluate the efficacy of this combined treatment strategy in enhancing overall survival (OS) and progression-free survival (PFS) compared to monotherapies.
METHODS
A systematic review was conducted following the PRISMA guidelines. A comprehensive search was performed across PubMed, EMBASE, Web of Science, and the Cochrane Library up to May 8, 2024. Studies were included if they compared sorafenib plus TACE to sorafenib alone or TACE alone in adults with advanced HCC. Primary outcomes were OS, PFS, response rates, and safety profiles. Data extraction and quality assessment were independently performed by two reviewers. Heterogeneity was assessed using the I² statistic, and a random-effects model was applied for pooling data. Sensitivity analysis and publication bias assessment were also conducted.
RESULTS
A total of twelve studies involving 1174 patients met the inclusion criteria. Significant heterogeneity was observed for both OS (I² = 72.6%, P < 0.001) and PFS (I² = 83.7%, P < 0.001). The combined treatment of sorafenib with TACE significantly improved OS [hazard ratio (HR) = 0.60, 95% confidence interval (CI): 0.44-0.76] and PFS (HR = 0.54, 95%CI: 0.38-0.69). Sensitivity analysis confirmed the robustness of these findings. Funnel plots and Egger's test indicated no significant publication bias.
CONCLUSION
Sorafenib combined with TACE significantly enhances both OS and PFS in patients with advanced HCC compared to monotherapy. This combination therapy represents a promising approach to improving clinical outcomes in advanced liver cancer.
Core Tip: This meta-analysis synthesizes current research to assess the efficacy of combining sorafenib with transarterial chemoembolization (TACE), aiming to enhance survival outcomes in patients with advanced hepatocellular carcinoma (HCC). Our comprehensive review, adhering to PRISMA guidelines, included twelve studies and 1174 patients, revealing that the combination therapy significantly improves both overall survival and progression-free survival compared to sorafenib or TACE alone. These results advocate for the integration of this combined approach in clinical practice, potentially setting a new benchmark in the treatment protocols for advanced HCC.
