title: Oxaliplatin-based chemotherapy: a new option in advanced hepatocellular carcinoma. a systematic review and pooled analysis.
abstract: Advanced hepatocellular carcinoma (HCC), for which locoregional treatment is not an option, is a candidate for palliative systemic therapy, but an accepted chemotherapy regimen does not exist. We have conducted a systematic literature review and meta-analyses to quantify the benefits of oxaliplatin (OXA)-based chemotherapy in advanced HCC in patients not exposed to sorafenib. Studies that enrolled advanced HCC patients treated with first-line OXA-based chemotherapy were identified using PubMed, Web of Science, SCOPUS, The Cochrane Register of Controlled Trials and EMBASE. A systematic review was conducted to calculate the pooled response rate and 95% confidence interval. The pooled median progression-free survival (PFS) and overall survival, weighted on the number of patients of each selected trials, were also calculated. We tested for significant heterogeneity by Cochran's chi-squared test and I-square index. Thirteen studies were included in this review, with a total of 800 patients analysed. The pooled response rate was 16.8%. The median PFS and overall survival were 4.2 and 9.3 months, respectively, with a 1 year overall survival of 37%. The weighted median PFS/overall survival and response rate were 4.5/11 months and 20% in Western patients. Conversely, in Asiatic studies, the median PFS/overall survival and response rate were 2.43/6.47 months and 13.2%, respectively. OXA-based chemotherapy is effective in advanced HCC and represents a viable option in these patients. A head to head comparison with sorafenib or a second-line agent should be verified in prospective trials.
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy. Electronic address: faupe@libero.it.
authors.forename: F
authors.initials: F
authors.lastname: Petrelli
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Coinu
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: K
authors.initials: K
authors.lastname: Borgonovo
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cabiddu
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ghilardi
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Lonati
authors.affiliation: Oncology Department, Medical Oncology Unit, Azienda Ospedaliera Treviglio, Treviglio, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Barni
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin
keywords: Advanced HCC; chemotherapy; first line; oxaliplatin; sorafenib