Meta-analysis Of Apatinib Combined With TACE In The Treatment Of Advanced Liver Cancer

Objective: There have been many studies on targeted drugs in recent years,but there are still some controversies about the efficacy and safety of targeted drugs combined with transcatheter arterial chemoembolization.There is no consistent clinical evidence.To compare the efficacy and safety of apatinib combined with TACE and TACE alone,and to provide a reference for clinical research.Methods:A computer-based search databasePubmed,Embase,Corchrane library,CNKI,a clinical controlled study comparing apatinib combined with TACE with simple TACE.Screening literature,extracting data,selecting random or fixed effect models according to the size of heterogeneity,using odds ratio(OR)as the effect amount to conduct meta-analysis of measurement data,using weighted mean difference(WMD)for meta-analysis of counting data,above The indicators were analyzed using Revman 5.3 software.Results:1?According to the inclusion and screening criteria,12 articles were included,including 10 Chinese articles and 2 English articles,including 394 patients receiving Apatinib combined with TACE and 390 patients receiving TACE alone.2?One year objective remission rate Statistical significance: OR = 3.27,95% CI = 2.27-4.70,P < 0.00001.The one-year survival rate was statistically significant: OR=2.18,95% CI=1.28-3.71,P=0.0004;3?Postoperative MMP-9 concentration was statistically significant: WMD=-536.68,95%CI=-622.78--450.57,P < 0.00001.The postoperative VEGF concentration was statistically significant: WMD=-109.13,95% CI=-142.77--75.48,P<0.00001;4?Four major adverse reactions and liver function: Hand-foot syndrome was statistically significant: OR=11.78 95% CI=1.73-80.13,P=0.01.After sensitivity analysis,there was no statistical significance: OR=2.10,95% CI=0.93-4.76,P=0.07.Bone marrow suppression was not statistically significant: OR=0.72,95% CI=0.39-1.31,P=0.28.Proteinuria was statistically significant: OR = 33.77,95% CI = 9.89-115.31,P < 0.00001.Hypertension was not statistically significant: OR = 6.37,95% CI = 0.81-50.25,P = 0.08.After sensitivity analysis,it was statistically significant.Postoperative aspartate aminotransferase: WMD=-7.45,95% CI=-32.40-17.49,P>0.05;postoperative alanine aminotransferase: WMD=-2.42,95% CI=--18.76-13.91,P>0.05;postoperative Total bilirubin: WMD =-1.35,95% CI =-10.30-7.60,P > 0.05.Conclusions:Apatinib combined with TACE is more effective than TACE alone in the treatment of advanced liver cancer,and the safety is still uncertain.