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Harms and benefits of adoptive immunotherapy for postoperative hepatocellular carcinoma: an updated review

View Article: PubMed Central - PubMed

ABSTRACT

The harms and benefits of adoptive immunotherapy (AIT) for patients with postoperative hepatocellular carcinoma (HCC) are controversial among studies. This study aims to update the current evidence on efficacy and safety of AIT for patients with HCC who have received curative therapy. Electronic databases were systematically searched to identify randomized controlled trials (RCTs) and cohort studies evaluating adjuvant AIT for patients with HCC after curative therapies. Recurrence and mortality were compared between patients with or without adjuvant AIT. Eight RCTs and two cohort studies involving 2,120 patients met the eligibility criteria and were meta-analyzed. Adjuvant AIT was associated with significantly lower recurrence rate than curative therapies alone at 1 year [risk ratio (RR) 0.64, 95%CI 0.49-0.82], 3 years (RR 0.85, 95%CI 0.79-0.91) and 5 years (RR 0.90, 95%CI 0.85-0.95). Similarly, adjuvant AIT was associated with significantly lower mortality at 1 year (RR 0.64, 95%CI 0.52-0.79), 3 years (RR 0.73, 95%CI 0.65-0.81) and 5 years (RR 0.86, 95%CI 0.79-0.94). Short-term outcomes were confirmed in sensitivity analyses based on RCTs or choice of a fixed- or random-effect meta-analysis model. None of the included patients experienced grade 3 or 4 adverse events. Therefore, this update reinforces the evidence that adjuvant AIT after curative treatment for HCC lowers risk of recurrence and mortality.

No MeSH data available.


Flow chart of study selection
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Figure 1: Flow chart of study selection

Mentions: A total of 538 studies were identified, which decreased to 256 after duplicates were removed. Screening the titles and abstracts led to a final set of 20 studies that were read in full [13–22, 23–32]. Of these, six studies [23–28] were excluded because they contained subsets of patients already contained in larger studies [14, 15, 21, 22]. Three studies investigating AIT for patients with advanced HCC were excluded [29–31], and another study investigating a different type of postoperative immunotherapy was excluded [32]. In the end, 8 RCTs [13–20] and 2 cohort studies [21, 22] involving 1,079 AIT-treated and 1041 untreated patients were included in the meta-analysis (Figure 1, Table 1).


Harms and benefits of adoptive immunotherapy for postoperative hepatocellular carcinoma: an updated review
Flow chart of study selection
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5392348&req=5

Figure 1: Flow chart of study selection
Mentions: A total of 538 studies were identified, which decreased to 256 after duplicates were removed. Screening the titles and abstracts led to a final set of 20 studies that were read in full [13–22, 23–32]. Of these, six studies [23–28] were excluded because they contained subsets of patients already contained in larger studies [14, 15, 21, 22]. Three studies investigating AIT for patients with advanced HCC were excluded [29–31], and another study investigating a different type of postoperative immunotherapy was excluded [32]. In the end, 8 RCTs [13–20] and 2 cohort studies [21, 22] involving 1,079 AIT-treated and 1041 untreated patients were included in the meta-analysis (Figure 1, Table 1).

View Article: PubMed Central - PubMed

ABSTRACT

The harms and benefits of adoptive immunotherapy (AIT) for patients with postoperative hepatocellular carcinoma (HCC) are controversial among studies. This study aims to update the current evidence on efficacy and safety of AIT for patients with HCC who have received curative therapy. Electronic databases were systematically searched to identify randomized controlled trials (RCTs) and cohort studies evaluating adjuvant AIT for patients with HCC after curative therapies. Recurrence and mortality were compared between patients with or without adjuvant AIT. Eight RCTs and two cohort studies involving 2,120 patients met the eligibility criteria and were meta-analyzed. Adjuvant AIT was associated with significantly lower recurrence rate than curative therapies alone at 1 year [risk ratio (RR) 0.64, 95%CI 0.49-0.82], 3 years (RR 0.85, 95%CI 0.79-0.91) and 5 years (RR 0.90, 95%CI 0.85-0.95). Similarly, adjuvant AIT was associated with significantly lower mortality at 1 year (RR 0.64, 95%CI 0.52-0.79), 3 years (RR 0.73, 95%CI 0.65-0.81) and 5 years (RR 0.86, 95%CI 0.79-0.94). Short-term outcomes were confirmed in sensitivity analyses based on RCTs or choice of a fixed- or random-effect meta-analysis model. None of the included patients experienced grade 3 or 4 adverse events. Therefore, this update reinforces the evidence that adjuvant AIT after curative treatment for HCC lowers risk of recurrence and mortality.

No MeSH data available.