Meta Analysis Of The Efficacy Of Immunotherapy Combined With Targeted Drugs For Intermediate To Advanced Hepatocellular Carcinoma

Objective:Liver cancer is not only a common malignant tumor,but also one of the main causes of cancer-related death.Most patients with liver cancer are in the advanced stage of the disease when they are diagnosed,and lack standard and effective treatment methods.Therefore,this study systematically evaluated the efficacy and safety of immune drugs combined with targeted drugs in the treatment of advanced liver cancer,and provided evidence-based medical evidence for clinicians to choose appropriate treatment regimens.Methods:The published articles on the efficacy of immune drugs combined with targeted drugs and targeted drugs alone in the treatment of advanced liver cancer were searched by computer in China National Knowledge Infrastructure,Wanfang Database,VIP Journal Chinese journals,China Biology Medicine Disc,Pub Med,Sciencedirect,EMbase、Cochrane Library and other domestic and foreign databases.The literature was screened by strictly following the inclusion and exclusion criteria.excel was used to extract the literature data such as CR,PR,SD,PD,ORR,OS,6-month survival rate,1-year survival rate and adverse reactions.The NOS evaluation scale was used to evaluate the quality of the literature.Rev Man5.4 software was used for statistical analysis.Results:A total of 9 studies were included in this study,including 4 retrospective studies and5 randomized controlled trials.The total number of patients was 2610.1699 patients of them were treated with immunotherapy combined with targeted drugs,and 911 patients were treated with targeted drugs alone.the combined treatment could significantly prolong the OS of advanced liver cancer(HR=0.80 [95%CI: 0.68-0.93] p=0.004).The6-month and 1-year survival rates were OR=1.68 [95%CI: 1.24-2.24] p=0.0004 and OR=1.42 [95%CI: 1.11-1.81] p=0.005,respectively.In solid tumor response,regardless of m RECIST or RECIST 1.1 criteria,there were significant differences in CR,PR and PD between the combination therapy group and the targeted therapy group(P < 0.05).There were statistically significant differences in the total number of adverse reactions,ALT,AST,proteinuria,fever,hypertension,hypothyroidism,fatigue,pruritus and peripheral edema between the two groups(P < 0.05).Conclusion:Immunotherapy combined with targeted drugs may increase the risk of adverse reactions in the treatment of liver cancer,but the combination therapy can improve tumor response and prolong the survival time of patients.Therefore,it is necessary for clinicians to strictly screen patients and choose the appropriate treatment plan according to the patient’s physical condition and laboratory indicators.