New molecular therapies in patients with advanced Hepatocellular Cancer in second line of treatment : is a real defeat? : Results from a literature based meta-analysis of randomized trials
A partir d'une revue de la littérature publiée jusqu'en février 2016 (5 études incluant au total 1 815 participants), cette méta-analyse évalue, du point de vue de la survie globale, l'efficacité de nouvelles thérapies ciblées (axitinib, brivanib, tivatinib, évérolimus et ramucirumab) en traitement de seconde ligne dans le cancer hépatocellulaire de stade avancé
Several new biological agents have been investigated as second line of treatment in advanced Hepatocellular Cancer (HCC). We performed a meta-analysis to assess the effect of targeted therapies in advanced HCC patients beyond the first line of treatment. A literature-based metaanalysis of randomized controlled trials was undertaken. The primary outcome was the overall survival. The secondary endpoints were the progression-free survival (PFS), the response rate (RR) and disease control rate (DCR) and the safety. Pooled analysis of targeted agents revealed a modest increase in overall survival compared with control arm (Hazard Ratio (HR) = 0.93, 95%CI: 0.83-1.04; P = 0.21). On the counterpart, all the secondary endpoints were in favoured to the targeted agents-based treatment (PFS: HR = 0.68, 95% CI:0.56-0.83; P = 0.0002; RR: 3.50,95% CI 1.81-6.76; P = 0.0002, DCR: RR:1.19, 95% CI 1.06-1.32; P = 0.002). To date, there is a clinical need of a more efficacious second line of therapy in treatment of the advanced HCC. This study showed some activity of the new targeted therapies in second line of treatment in advanced HCC.