Efficacy and safety of immune checkpoint therapy in hepatocellular carcinoma: meta-analysis

Abstract

Aim: Immune checkpoint inhibitors (ICIs) are proven to be an effective way to treat the disease of hematologic malignancies. But there is still plenty of uncertainty about the effectiveness of ICIs on hepatocellular carcinoma. The Meta-analysis was conducted to evaluate the efficacy and safety of ICIs treatment in patients with HCC.

Methods: Four electronic databases, including PubMed, Embase, Cochrane database, and ClinicalTrials.gov, were systematically retrieved for relevant observational studies published before November 1, 2018. The objective response rate (ORR) and adverse events were analyzed. Meta and Metafor Packages in R were utilized to accomplish meta proportion analysis.

Results: A total of 462 patients from 7 studies were included in this meta-analysis. The pooled estimated ORR of ICIs was 19.8% (95% CI 16.4% to 23.7%). No substantial heterogeneity was observed among studies (Q = 2.0427, P = 0.92, I² = 0.0%). The common adverse events on any grade were saw in increased AST (22.7%, 95%CI 13.8% to 35.2%), fatigue (20.9%, 95%CI 10.9% to 36.3%), rash (18.5%, 95%CI 8.9% to 34.4%) and pruritus (17.3%, 95%CI 13.5% to 21.8%). Increased AST (9.9%, 95%CI 4.4% to 21.0%) and increased ALT (5.8%, 95%CI 3.7% to 8.9%) were the most common adverse events on grade greater than 3.

Conclusion: Although ICIs treatment has a certain efficacy on liver cancer, it also causes some adverse events which should be noticed by clinicians.

Keywords

Hepatocellular / immune-checkpoint inhibitor / CLAT-4 / PD1/PD-L1

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