Efficacy and safety of transarterial chemoembolization (TACE) plus sorafenib vs TACE alone in the treatment of non-resectable hepatocellular carcinoma: A systematic review and meta-analysis.

Abstract

e16213 Background: Hepatocellular carcinoma (HCC) poses a significant global health challenge, with limited treatment options for non-resectable cases. This meta-analysis aims to evaluate the safety and efficacy of combining transarterial chemoembolization (TACE) with sorafenib compared to TACE alone in treating non-resectable HCC. Methods: A systematic literature search following PRISMA guidelines identified 10 studies (n = 1818 patients) meeting inclusion criteria. The quality of the studies was assessed using the Jadad and Newcastle-Ottawa scales. Data extraction included baseline characteristics, overall survival, adverse events, and treatment specifics. Statistical analyses were performed using Review Manager 5.4. We used a random-effects model to pool risk ratio (RR) along with their 95% confidence intervals (CI). Results: TACE plus sorafenib demonstrated a significantly higher objective response rate (ORR) (RR = 1.18, 95% CI: 1.04–1.33, p = 0.010) and disease control rate (DCR) (RR = 1.12, 95% CI: 1.02-1.24, p = 0.02) compared to TACE alone. Adverse events such as diarrhea, fatigue, weight loss, hand-foot skin reactions, rash, alopecia, and fever were more prevalent in the combination therapy group. Conclusions: TACE plus sorafenib demonstrated superior efficacy in terms of ORR and DCR compared to TACE alone in non-resectable HCC. However, the higher incidence of adverse events emphasizes the need for careful consideration of risk-benefit profiles in clinical decision-making.