Lenvatinib联合程序性死亡受体-1治疗肝癌有效性与安全性系统评价与Meta分析

目的 全面客观评价Lenvatinib联合程序性死亡受体-1(PD-1)抑制剂对晚期肝癌治疗的安全性和有效性，为临床指导实践提供可靠证据。方法 对PubMed、Web of Science、Embase、The Cochrane Library、中国生物医学文献服务系统、维普数据库、万方数据库、中国知网等数据库检索有关Lenvatinib联合PD-1治疗肝癌的随机对照试验或者单臂临床试验。按纳入排除标准对文献信息筛选提取，用RevMan5.4和STATA15对数据Meta分析。结果 本文纳入7篇文献，符合研究的患者共335名。经过Meta分析后提示，相比单用Lenvatinib组，Lenvatinib联合PD-1抑制剂治疗肝癌的客观缓解率和疾病控制率均显著提高（客观缓解率：RR=1.87,95%CI:0.75～4.66；疾病控制率：RR=1.26,95%CI:0.98～1.61）。然而，Lenvatinib联合PD-1抑制剂组更加容易引起蛋白尿、甲状腺功能减退、消化道出血等药物不良反应。结论 与单用Lenvatinib比，Lenvatinib联合PD-1抑制剂可显著提高肝癌患者的客观缓...

Lenvatinib combined with PD-1 inhibitor for advanced hepatocarcinoma: A meta-analysis

Objective To evaluate the clinical efficacy and safety of lenvatinib combined with programmed death-1 (PD-1) inhibitor for advanced hepatocarcinoma, and to provide the reference for clinical practice and research. Methods The following databases as the PubMed, The Cochrane Library, Embase, Web of Science and CBM, CNKI, VIP and WanFang Data were searched electronically. All randomized controlled trials (RCTs) and single-arm trials on lenvatinib combined with PD-1 inhibitor for hepatocarcinoma were collected. The literature was screened according to inclusive criteria, data were extracted and the quality of included studies was assessed, and then meta-analysis was conducted using RevMan 5.4 and STATA15 software. Results A total of 7 studies with 335 patients were included. Meta-analysis showed that compared with lenvatinib alone, lenvatinib combined with PD-1 inhibitor had a significant improvement in objective response rate (RR=1.87, 95%CI:0.75 to 4.66) and disease control rate (RR=1.26, 95%CI: 0.98 to 1.61). Howerver, lenvatinib combined with PD-1 inhibitor group is more likely to cause the incidences of proteinuria and hypothyroidism. Conclusions Compared with lenvatinib alone, lenvatinib combined with PD-1 inhibitor can improve objective response rate and disease control rate. It is worth noting that, the side effects which may occur in the combined therapy need to be carefully treated in clinical use. Taken together, lenvatinib combined with PD-1 inhibitor may be of great significance in the treatment of patients with advanced liver cancer.