First- and Second-Line Treatments for Patients with Advanced Hepatocellular Carcinoma in China: A Systematic Review

Chinese national guidelines recommend various systemic therapies for patients with advanced hepatocellular carcinoma (HCC), but optimal treatment selection remains uncertain. To summarize the evidence supporting the systemic treatment of Chinese patients with advanced HCC, we performed a systematic...

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Published in:	Current oncology (Toronto) 2022-09, Vol.29 (10), p.7305-7326
Main Authors:	Zhang, Lan, Sun, Junhui, Wang, Kui, Zhao, Haitao, Zhang, Xijie, Ren, Zhenggang
Format:	Article
Language:	eng
Subjects:	Adolescent Adult B7-H1 Antigen Bevacizumab - therapeutic use Biosimilar Pharmaceuticals Cancer Carcinoma, Hepatocellular - drug therapy Chemotherapy China hepatocellular carcinoma Hepatoma Humans Immune Checkpoint Inhibitors Liver Neoplasms - drug therapy Programmed Cell Death 1 Receptor Prospective Studies Protein Kinase Inhibitors Retrospective Studies Systematic Review systemic therapy
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Summary:	Chinese national guidelines recommend various systemic therapies for patients with advanced hepatocellular carcinoma (HCC), but optimal treatment selection remains uncertain. To summarize the evidence supporting the systemic treatment of Chinese patients with advanced HCC, we performed a systematic review using a literature search of PubMed, Embase, China National Knowledge Infrastructure, and the Chinese Scientific Journal Database between 1 January 2009 and 15 June 2021, and abstracts from ASCO 2020, ASCO GI 2021, ESMO 2020, and ESMO GI 2020. The inclusion criteria were: Chinese patients aged ≥18 years with advanced HCC; first- or second-line systemic therapy; an evaluation of the efficacy or safety outcomes; and a randomized controlled, non-randomized controlled, prospective, or retrospective design. Thirty reports were identified for the following therapies: the single-agent tyrosine kinase inhibitor (TKI; = 10), single-agent programmed death-1 (PD-1) inhibitor ( = 4), chemotherapy ( = 5), PD-1/programmed death-ligand 1 (PD-L1) inhibitor plus TKI ( = 6), PD-1/PD-L1 inhibitor plus bevacizumab or biosimilar ( = 4), and PD-1/PD-L1 inhibitor plus chemotherapy ( = 1). The heterogeneity between the studies precluded statistical analysis and the data were summarized using tables. In the first-line setting, evidence supported the use of atezolizumab or sintilimab plus bevacizumab or a biosimilar. There remains insufficient evidence to determine the optimal approved TKI-based therapeutic option, and active controlled trials in the second-line setting were lacking.
ISSN:	1718-7729 1198-0052 1718-7729