The long-term efficacy of cytokine-induced killer cellular therapy for hepatocellular carcinoma: a meta-analysis

Immunotherapy ◽  
2019 ◽  
Vol 11 (15) ◽  
pp. 1325-1335 ◽  
Author(s):  
Jiaxue Wang ◽  
Tiantian Shen ◽  
Qi Wang ◽  
Tan Zhang ◽  
Lujin Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Recurrence Rate ◽  
Randomized Clinical Trials ◽  
Cellular Therapy ◽  
Therapy Group ◽  
Meta Analysis ◽  
Control Group ◽  
Term Efficacy

Aim: The long-term efficacy of cytokine-induced killer cellular therapy for hepatocellular carcinoma patients after curative treatments remains controversial. Methods: A meta-analysis was conducted, and the outcomes were the recurrence rate and overall survival. Results: Eight randomized clinical trials with 1038 participants were included. Compared with the control group, cytokine-induced killer cellular therapy group could reduce 1-year, 3-year recurrence rates, as well as improve 1–5 years overall survival for hepatocellular carcinoma patients (p < 0.05). However, it failed to affect the 5-year recurrence rate and 6-year overall survival (p > 0.05). Conclusion: Cytokine-induced killer cellular adjuvant therapy exerted a favorable role in improving early and long-term efficacy for hepatocellular carcinoma patients.

scholarly journals The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

2021 ◽  
Vol 28 ◽  
pp. 107327482199743
Author(s):  
Ke Chen ◽  
Xiao Wang ◽  
Liu Yang ◽  
Zheling Chen
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Survival Rate ◽  
Meta Analysis ◽  
Response Rates ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

scholarly journals Association of Leptin and Adiponectin with Risk and Prognosis of Hepatocellular Carcinoma: A Combination of Traditional, Survival and Dose-response Meta-analysis

2020 ◽  
Author(s):  
Lilong Zhang ◽  
Qihang Yuan ◽  
Man Li ◽  
Dongqi Chai ◽  
Wenhong Deng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Meta Analysis ◽  
Healthy Control Group ◽  
Cochrane Library ◽  
Control Group ◽  
Linear Relationships ◽  
Increased Risk ◽  
Healthy Control ◽  
Carcinoma Risk

Abstract Background: The association between leptin, adiponectin levels and the risk as well as prognosis of hepatocellular carcinoma has been investigated by an increasing number of studies, but the results were controversial.Methods: A meta-analysis was performed to assess the correlation between leptin, adiponectin levels and risk and prognosis of hepatocellular carcinoma (CRD42020195882). Through June 14, 2020, PubMed, Cochrane Library, Embase databases, Clinicaltrials, and Opengrey were searched, including references of qualifying articles. Titles, abstracts, and main texts were reviewed by at least 2 independent readers. Stata 16.0 was used to calculate statistical data.Results: Thirty studies were included in this meta-analysis and results showed that hepatocellular carcinoma group had significantly higher leptin levels than the cancer-free control group (SMD = 1.83, 95% CI (1.09, 2.58), P = 0.000) , the healthy control group (SMD = 4.32, 95% CI (2.41, 6.24), P = 0.000) and the cirrhosis group (SMD = 1.85, 95% CI (0.70, 3.01), P = 0.002). Hepatocellular carcinoma group had significantly higher adiponectin levels than the healthy control group (SMD = 1.57, 95% CI (0.37, 2.76), P = 0.010), but no statistical difference compared with the cancer-free control group (SMD = 0.24, 95% CI (-0.35, 0.82), P = 0.430) and the cirrhosis group (SMD = -0.51, 95% CI (-1.30, 0.29), P= 0.213). The leptin rs7799039 polymorphism was associated with increased risk of hepatocellular carcinoma (G vs A: OR = 1.28, 95% CI (1.10, 1.48), P = 0.002). There were linear relationships between adiponectin levels and the risk of hepatocellular carcinoma (OR = 1.066, 95% CI (1.03, 1.11), P = 0.001). In addition, the results showed that high/positive expression of adiponectin was significantly related to lower overall survival in hepatocellular carcinoma patients (HR = 1.70, 95% CI (1.22, 2.37), P = 0.002); however, there was no significantly association between the leptin levels and overall survival (HR = 0.92, 95% CI (0.53, 1.59), P = 0.766).Conclusion: The study shows that high leptin levels are associated with a higher risk of hepatocellular carcinoma. Adiponectin levels are proportional to hepatocellular carcinoma risk, and are related to the poor prognosis.

scholarly journals The association of leptin and adiponectin with hepatocellular carcinoma risk and prognosis: a combination of traditional, survival, and dose-response meta-analysis

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lilong Zhang ◽  
Qihang Yuan ◽  
Man Li ◽  
Dongqi Chai ◽  
Wenhong Deng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Meta Analysis ◽  
Healthy Control Group ◽  
Cochrane Library ◽  
Control Group ◽  
Linear Relationships ◽  
Increased Risk ◽  
Healthy Control ◽  
Carcinoma Risk

Abstract Background An increasing number of studies have focused on the association between leptin, adiponectin levels and the risk as well as the prognosis of hepatocellular carcinoma. However, the reported results are conflicting. Methods A meta-analysis was performed to assess the correlation between leptin, adiponectin levels and risk and prognosis of hepatocellular carcinoma (CRD42020195882). Through June 14, 2020, PubMed, Cochrane Library and EMBASE databases were searched, including references of qualifying articles. Titles, abstracts, and main texts were reviewed by at least 2 independent readers. Stata 16.0 was used to calculate statistical data. Results Thirty studies were included in this meta-analysis and results showed that hepatocellular carcinoma group had significantly higher leptin levels than the cancer-free control group (SMD = 1.83, 95% CI (1.09, 2.58), P = 0.000), the healthy control group (SMD = 4.32, 95% CI (2.41, 6.24), P = 0.000) and the cirrhosis group (SMD = 1.85, 95% CI (0.70, 3.01), P = 0.002). Hepatocellular carcinoma group had significantly higher adiponectin levels than the healthy control group (SMD = 1.57, 95% CI (0.37, 2.76), P = 0.010), but no statistical difference compared with the cancer-free control group (SMD = 0.24, 95% CI (− 0.35, 0.82), P = 0.430) and the cirrhosis group (SMD = − 0.51, 95% CI (− 1.30, 0.29), P = 0.213). The leptin rs7799039 polymorphism was associated with increased risk of hepatocellular carcinoma (G vs A: OR = 1.28, 95% CI (1.10, 1.48), P = 0.002). There were linear relationships between adiponectin levels and the risk of hepatocellular carcinoma (OR = 1.066, 95% CI (1.03, 1.11), P = 0.001). In addition, the results showed that high/positive expression of adiponectin was significantly related to lower overall survival in hepatocellular carcinoma patients (HR = 1.70, 95% CI (1.22, 2.37), P = 0.002); however, there was no significantly association between the leptin levels and overall survival (HR = 0.92, 95% CI (0.53, 1.59), P = 0.766). Conclusion The study shows that high leptin levels were associated with a higher risk of hepatocellular carcinoma. Adiponectin levels were proportional to hepatocellular carcinoma risk, and were related to the poor prognosis.

scholarly journals Long-Term Survival, Vascular Occlusive Events and Efficacy Biomarkers of First-Line Treatment of CML: A Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1242
Author(s):  
Hélène Haguet ◽  
Carlos Graux ◽  
François Mullier ◽  
Jean-Michel Dogné ◽  
Jonathan Douxfils
Keyword(s):  
Overall Survival ◽  
Second Generation ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Arterial Occlusion ◽  
Molecular Response ◽  
Cardiovascular Risks ◽  
Clinical Registry ◽  
Term Survival

Large randomized clinical trials and prior meta-analyses indicate that second-generation BCR-ABL tyrosine kinase inhibitors (TKIs) improve surrogate biomarkers in patients with chronic myeloid leukemia (CML) without providing survival benefits. The objective is to evaluate the long-term efficacy and the occurrence of vascular occlusion with second-generation BCR-ABL TKIs compared with imatinib in patients with CML. Three scientific databases, a clinical registry and abstracts from congress were searched to identify all randomized controlled trials that compared a second-generation BCR-ABL TKI to imatinib in patients with CML. Outcomes extracted were overall survival, major molecular response and complete cytogenetic response, arterial occlusive events and venous thromboembolism. These data were synthesized by odds ratios using a fixed-effect model. This meta-analysis included 4659 participants from 14 trials. Second-generation BCR-ABL TKIs did not improve overall survival compared with imatinib, even at longer follow-up (OR, 1.17 (95% CI, 0.91–1.52)). They improved surrogate biomarkers at 12 and 24 months but increased the risk of arterial occlusion (ORPETO, 2.81 (95% CI, 2.11–3.73)). The long-term benefits of second-generation TKIs are restricted to surrogate outcomes and do not translate into prolonged survival compared to imatinib. Given the long-term use, frontline therapy should be chosen carefully, with special attention to the patients’ quality of life and cardiovascular risks.

scholarly journals Efficacy of Nucleot(s)ide Analogs Therapy in Patients with Unresectable HBV-Related Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Lingling He ◽  
Xiaoli Liu ◽  
Yalin Zhao ◽  
Shuan Zhang ◽  
Yuyong Jiang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Best Practice ◽  
Therapy Group ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Treated Group ◽  
Sensitivity Analyses ◽  
Secondary Outcome ◽  
Control Group ◽  
Free Survival

Aim. To determine whether nucleot(s)ide analogs therapy has survival benefit for patients with HBV-related HCC after unresectable treatment.Method. A systematic search was conducted through seven electronic databases including PubMed, OVID, EMBASE, Cochrane Databases, Elsevier, Wiley Online Library, and BMJ Best Practice. All studies comparing NA combined with unresectable treatment versus unresectable treatment alone were considered for inclusion. The primary outcome was the overall survival (OS) after unresectable treatment for patients with HBV-related HCC. The secondary outcome was the progression-free survival (PFS). Results were expressed as hazard ratio (HR) for survival with 95% confidence intervals.Results. We included six studies with 994 patients: 409 patients in nucleot(s)ide analogs therapy group and 585 patients without antiviral therapy in control group. There were significant improvements for the overall survival (HR = 0.57; 95% CI = 0.47–0.70;p< 0.001) and progression-free survival (HR = 0.84; 95% CI = 0.71–0.99;p= 0.034) in the NA-treated group compared with the control group. Funnel plot showed that there was no significant publication bias in these studies. When it comes to antiviral drugs and operation method, it also showed benefit in NA-treated group. At the same time, overall mortality as well as mortality secondary to liver failure in NA-treated group was obviously lesser. Sensitivity analyses confirmed the robustness of the results.Conclusions. Nucleot(s)ide analogs therapy after unresectable treatment has potential beneficial effects in terms of overall survival and progression-free survival. NA therapy should be considered in clinical practice.

Effectiveness and Safety of Combination Therapy of Transarterial Chemoembolization and Apatinib for Unresectable Hepatocellular Carcinoma in the Chinese Population: A Meta-Analysis

Chemotherapy ◽  
2019 ◽  
Vol 64 (2) ◽  
pp. 94-104 ◽  
Author(s):  
Yan Wei ◽  
Jianjun Liu ◽  
Min Yan ◽  
Shuguang Zhao ◽  
Yong Long ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Combination Therapy ◽  
Transarterial Chemoembolization ◽  
Therapy Group ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Advanced Hepatocellular Carcinoma ◽  
Combination Therapy Group ◽  
Advanced Hcc

Background: The combination of transarterial chemoembolization (TACE) and apatinib has been used in the treatment of intermediate or advanced hepatocellular carcinoma (HCC). However, its effectiveness and safety are also argued. Methods: Eligible studies were collected from a computer search of literatures published from the database establishment to May 2019 in PubMed, Web of Science, EMBASE, Ovid, the Cochrane Library, Wanfang Database, China National Knowledge Infrastructure, and China Biology Medicine Disc. The objective response rate (ORR), the disease control rate (DCR), survival rate (SR), and the incidences of treatment-related adverse effects (AEs) were collected as the relevant outcomes. Data were analyzed through fixed/random effects of meta-analysis models with RevMan 5.3 software. Results: Eight randomized controlled clinical trials comprising 528 patients and 4 cohort studies comprising 226 patients were eventually included. Compared to the control group treated with TACE solely, combination therapy group, in which intermediate or advanced HCC patients were treated with TACE and apatinib, significantly enhanced ORR (relative risk [RR] 2.06, 95% CI 1.63–2.61, p < 0.001), DCR (RR 1.65, 95% CI 1.24–2.20, p < 0.001), and whole SRs of 6-month (RR 1.52, 95% CI 1.08–2.14, p = 0.02), 1-year (RR 1.52, 95% CI 1.25–1.84, p < 0.001), and 2-year (RR 1.84, 95% CI 1.34–2.54, p < 0.001). The incidence of hand foot syndrome, proteinuria, hypertension, and diarrhea was significantly increased in the combination therapy group compared with the control group (p < 0.05), and the incidence of nausea and vomiting, fever, and myelosuppression, respectively, was similar in 2 groups (p > 0.05). Conclusions: The combination therapy of TACE and apatinib can enhance the clinical effectiveness better than TACE solely in patients with intermediate or advanced HCC, while increase in the AEs is usually tolerable.

scholarly journals Bisegmentectomy 7–8 for Small-for-Size Remanant Liver for Cirrhotic Patients Under Right Hemi-hepatectomy With Hepatocellular Carcinoma: A Case-Matched Comparative Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xishu Wang ◽  
Yongrong Lei ◽  
Hongbo Huan ◽  
Shu Chen ◽  
Kuansheng Ma ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Morbidity Rate ◽  
Control Group ◽  
Study Group ◽  
Liver Remnant ◽  
Long Term Treatment ◽  
Small For Size

Aim: To compare the short- and long-term treatment outcomes of bisegmentectomy 7–8 vs. right hepatectomy for patients with hepatocellular carcinoma and cirrhosis.Methods: Thirty six cirrhotic HCC patients with infiltration of right hepatic vein in segments 7–8 underwent bisegmentectomy 7–8 for small-for-size remanant liver under right hemi-hepatectomy. Its outcome was compared with a case-matched control group of cirrhotic HCC patients who underwent right hemi-hepatectomy during the study period.Results: The study group consisted of 36 patients and the control group 36 patients selected from 1,526 patients matched with age, tumor size, tumor location, and Pugh-Child staging. There were no significant differences between the two groups in operative parameters and in perioperative main complications which included hemorrhage, bile leakage, ascites, pleural effusion, and liver failure. The overall morbidity rate and morbidity rate classified according to Clavien's classification were similar. There was no in-hospital mortality or 90 day post-operative mortality. The mean follow-up was 30 and 32 months for the study group and control group, respectively. The disease free survival rate (DFS) for the study group was just significantly better than the control group. The median DFS was 24 months for the study group and 8 months for the control group (P = 0.049). Meanwhile, the median cumulative overall survival was 35 months for the study group and 27 months for the control group (P = 0.494).Conclusion: Bisegmentectomy 7–8 was safe and feasible for selected cirrhosis patients, and did not increase the perioperative risk and inferior long-term overall survival outcomes. It extended the indications for liver resection in patients with borderline volumes of future liver remnant for HCC cirrhotic liver.

scholarly journals Association of Circulating Leptin and Adiponectin with Risk and Prognosis of Hepatocellular carcinoma: A Combination of Traditional, Survival and Dose-response Meta-analysis

2020 ◽  
Author(s):  
Lilong Zhang ◽  
Qihang Yuan ◽  
Man Li ◽  
Dongqi Chai ◽  
Wei-Xing Wang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Meta Analysis ◽  
Healthy Control Group ◽  
Cochrane Library ◽  
Control Group ◽  
Positive Expression ◽  
Linear Relationships ◽  
Healthy Control ◽  
Carcinoma Risk

Abstract Background: The association between leptin, adiponectin levels and the risk and prognosis of hepatocellular carcinoma has been investigated by a growing number of studies, but the results were controversial. Methods: We performed the meta-analysis to assess the relationships between leptin, adiponectin levels and the risk and prognosis of hepatocellular carcinoma (CRD42020195882). Through June 14, 2020, PubMed, Cochrane Library, Embase databases, Clinicaltrials, and Opengrey was searhed, including references of qualifying articles. Titles, abstracts, and articles were reviewed by at least 2 independent readers. Stata 16.0 was used to calculate statistical data. Results: Thirty studies were included in this meta-analysis and results showed that hepatocellular carcinoma group has significantly higher leptin levels than the cancer-free control group (SMD = 1.83, 95% CI (1.09, 2.58), P = 0.000) , the healthy control group (SMD = 4.32, 95% CI (2.41, 6.24), P = 0.000) and the cirrhosis group (SMD = 1.85, 95% CI (0.70, 3.01), P = 0.002). Hepatocellular carcinoma group has significantly higher adiponectin levels than the the healthy control group (SMD = 1.57, 95% CI (0.37, 2.76), P = 0.010), but no statistical difference compared with the cancer-free control group (SMD = 0.24, 95% CI (-0.35, 0.82), P = 0.430) and the cirrhosis group (SMD = -0.51, 95% CI (-1.30, 0.29), P= 0.213). The leptin rs7799039 polymorphism was associated with an increased the risk of hepatocellular carcinoma (G vs A: OR = 1.28, 95% CI (1.10, 1.48), P = 0.002). There were linear relationships between adiponectin levels and the risk of hepatocellular carcinoma (OR = 1.066, 95% CI (1.03, 1.11), P = 0.001). In addition, the results showed that high/positive expression of adiponectin was significantly related to lower overall survival in hepatocellular carcinoma patients (HR = 1.70, 95% CI (1.22, 2.37), P = 0.002); however, there was no significantly association between the leptin levels and overall survival (HR = 0.92, 95% CI (0.53, 1.59), P = 0.766). Conclusion: The study shows that high leptin levels were associated with a higher risk of hepatocellular carcinoma. Adiponectin levels were proportional to hepatocellular carcinoma risk, and were related to the poor prognosis.

A meta-analysis of the clinical efficacy of the combination of acupuncture and Chinese medicine in the treatment of haemorrhoids

2019 ◽  
Vol 44 (2) ◽  
pp. 89-104
Author(s):  
Mengjie Zeng ◽  
Xueli Cheng ◽  
Geer Chen ◽  
Jiyou Kou
Keyword(s):  
Chinese Medicine ◽  
Recurrence Rate ◽  
Clinical Efficacy ◽  
Randomized Clinical Trials ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Effective Rate ◽  
Control Group ◽  
Clinical Effects ◽  
Pruritus Ani

At present, surgical resection is the main method of the treatment of haemorrhoids, but is easy to recur after surgery. Recently, it is reported that acupuncture has a beneficial influence on haemorrhoids. Thus, whether acupuncture is effective in the treatment of haemorrhoids is the key in this meta-analysis. To evaluate the clinical efficacy of the treatment of combination of acupuncture and Chinese medicine in haemorrhoids by meta-analysis, which provide a scientific, effective and feasible evidence for clinical decision-making and practice. A systematic review and meta-analysis of randomized clinical trials (RCTs). A meta-analysis was performed by using Review Manager 5.3. All RCTs about combination of acupuncture and Chinese medicine versus Chinese medicine alone were selected and assessed for inclusion. The effective rate (ER), recurrence rate(RR), Symptom score before and after treatment (perianal edema, hemafecia, perianal pain, pruritus ani, prolapse of haemorrhoids) were the outcomes analyzed in this meta-analysis. II RCTs and 976 patients were included. The methodological quality of most included trials was low to moderate. In this meta-analysis, the clinical efficacy of combination of acupuncture and Chinese medicine was more effective than only Chinese medicine used in haemorrhoids. The effective rate [OR=5.24,95%CI(3.72,7.40), P<O. OOOOI], recurrence rate [OR=O.29, 95%CI(O. II, O.73), P=O.009], perianal edema [WMD=-O.74,95%CI-O.90 to-O.59, P<O. OOOOI], hemafecia[WMD=-O.78,95%CI-O.89 to-O.67. P<O. OOOOI], perianal pain[WMD=-O.72,95%CI-O.94 to-O.50, P<O. OOOOI], pruritus ani[WMD=-O.75,95%CI-O.92 to-O.58, P<O. OOOOI] and prolapse of haemorrhoids[WMD=-0.43,95%CI-O.84 to-O.02, P=O.04] were shown in this meta-analysis.(OR:odds ratio;CI:confidence interval;WMD: weighted mean difference). There was about 96% of the clinical efficiency in the treatment of acupuncture plus Chinese medicine in haemorrhoids and 89% of that used in Chinese medicine alone, which indicates clearly that 7% higher efficiency in the experimental group compared with the control group. The treatment of combination of acupuncture and Chinese medicine in haemorrhoids is more useful than Chinese medicine alone applied in piles, which is shown in 91% of clinical effects in average.

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