Immune Checkpoint Inhibitors for Child-Pugh Class B Advanced Hepatocellular Carcinoma

作者：Enrui Xie, Yee Hui Yeo, Bernhard Scheiner, Yue Zhang, Atsushi Hiraoka, Xinxing Tantai, Petros Fessas, Tiago B. R. Castro, Antonio D’Alessio, Claudia Angela Maria Fulgenzi, Shuo Xu, Hong‐Ming Tsai, Swetha Kambhampati Thiruvengadam, Wenjun Wang, Bridget P. Keenan, Xu Gao, Zixuan Xing, Matthias Pinter, Yih‐Jyh Lin, Zhanjun Guo, Arndt Vogel, Takaaki Tanaka, Hsin‐Yu Kuo, Robin Kate Kelley, Masatoshi Kudo, Ju Dong Yang, David James Pinato, Fanpu Ji · 发表于：JAMA Oncology · 年份：2023 · DOI：10.1001/jamaoncol.2023.3284 · 被引用次数：85 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cancer Immunotherapy and Biomarkers、Cholangiocarcinoma and Gallbladder Cancer Studies

Importance: Immune checkpoint inhibitors (ICIs) are increasingly used in patients with advanced hepatocellular carcinoma (HCC). However, data on ICI therapy in patients with advanced HCC and impaired liver function are scarce. Objective: To conduct a systematic review and meta-analysis to determine the efficacy and safety of ICI treatment for advanced HCC with Child-Pugh B liver function. Data Sources: PubMed, Embase, Web of Science, and Cochrane Library were searched for relevant studies from inception through June 15, 2022. Study Selection: Randomized clinical trials, cohort studies, or single-group studies that investigated the efficacy or safety of ICI therapy for Child-Pugh B advanced HCC were included. Data Extraction and Synthesis: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was followed to extract data. A random-effects model was adopted if the heterogeneity was significant (I2 > 50%); otherwise, a fixed-effect model was used. Main Outcomes and Measures: The objective response rate (ORR) and overall survival (OS) were considered to be the primary efficacy outcomes of ICI treatment for Child-Pugh B advanced HCC, and the incidence of treatment-related adverse events (trAEs) was set as the primary measure for the safety outcome. Results: A total of 22 studies including 699 patients with Child-Pugh B and 2114 with Child-Pugh A advanced HCC comprised the analytic sample (median age range, 53-73 years). Upon pooled analysis, patients tre...