Integrating Quality of Life and Survival in Systemic Therapy for Advanced Hepatocellular Carcinoma

作者：Ciro Celsa, Gabriele Di Maria, Pasquale Lombardi, Antonio D’Alessio, Claudia Angela Maria Fulgenzi, Leonardo Brunetti, Giulia Francesca Manfredi, Bernardo Stefanini, Alba Sparacino, Cristina Rigamonti, Mario Pirisi, Charles Latchford, Marco Vaccaro, Marco Enea, Calogero Cammà, Giuseppe Cabibbo, David J. Pinato · 发表于：JAMA Oncology · 年份：2025 · DOI：10.1001/jamaoncol.2025.2470 · 被引用次数：9 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cancer Immunotherapy and Biomarkers、Cholangiocarcinoma and Gallbladder Cancer Studies

Importance: Multiple immunotherapy-based combinations and tyrosine kinase inhibitors are approved for first-line treatment of unresectable or advanced hepatocellular carcinoma (HCC). While overall survival remains the primary efficacy end point, health-related quality of life (HR-QoL) represents a crucial complementary outcome that has not been comprehensively compared across available treatments. Objective: To compare the HR-QoL effects associated with different first-line treatments for unresectable or advanced HCC and to integrate treatment-induced survival benefit with impact on patients' HR-QoL. Data Sources: The MEDLINE, CENTRAL, and Scopus databases were systematically searched for studies published from inception through November 2024. The search was supplemented with manual reviews of reference lists and abstracts from main oncology conferences from the past 5 years (2020-2024). Study Selection: Phase 3 randomized clinical trials comparing tyrosine kinase inhibitor monotherapy to immune checkpoint inhibitor-based therapies in first-line advanced HCC and reporting HR-QoL deterioration were included. Data Extraction and Synthesis: Study selection and data extraction were performed by 2 independent reviewers, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Cochrane Collaboration tool was used to assess risk of bias. A bayesian network meta-analysis was performed using sorafenib as the comparator. Main Outcomes and Measures: T...