Efficacy of combined transarterial radioembolization and sorafenib in the treatment of hepatocarcinoma: A meta-analysis

Background Adjuvant sorafenib may further enhance the efficacy of transarterial radioembolization for the treatment of hepatocellular carcinoma. Aims To evaluate the efficacy and safety of radioembolization plus sorafenib in hepatocellular carcinoma patients. Methods With a literature search through October 2020, we identified 9 studies (632 patients). Primary outcome was overall survival. Results were expressed as pooled median, odds ratio, or hazard ratio and 95% confidence intervals. Results Pooled overall survival after radioembolization plus sorafenib was 10.79 months (95% confidence interval 9.19–12.39) and it was longer in Barcelona Clinic Liver Cancer (BCLC) B (14.47 months, 9.07–19.86) as compared to BCLC C patients (10.22 months, 7.53–12.9). No difference between combined therapy versus radioembolization alone was observed in terms of overall survival (hazard ratio 1.07, 0.89–1.30). Pooled median progression-free survival was 6.32 months (5.68–6.98), with 1-year progression-free survival pooled rate of 38.5% (12.7%-44.2%). No difference in progression-free survival (hazard ratio 0.94, 0.79–1.12) between the two treatments was observed. Pooled rate of severe adverse events was 48.9% (26.7%-71.2%), again with no difference between the two treatment regimens (odds ratio 1.52, 0.15–15.02). Conclusions The association of sorafenib does not seem to prolong survival nor delay disease progression in patients treated with radioembolization.