title: New molecular therapies in patients with advanced Hepatocellular Cancer in second line of treatment: Is a real defeat?: Results from a literature based meta-analysis of randomized trials.
abstract: Several new biological agents have been investigated as second line of treatment in advanced Hepatocellular Cancer (HCC). We performed a meta-analysis to assess the effect of targeted therapies in advanced HCC patients beyond the first line of treatment. A literature-based metaanalysis of randomized controlled trials was undertaken. The primary outcome was the overall survival. The secondary endpoints were the progression-free survival (PFS), the response rate (RR) and disease control rate (DCR) and the safety. Pooled analysis of targeted agents revealed a modest increase in overall survival compared with control arm (Hazard Ratio (HR)=0.93, 95%CI: 0.83-1.04; P=0.21). On the counterpart, all the secondary endpoints were in favoured to the targeted agents-based treatment (PFS: HR=0.68, 95% CI:0.56-0.83; P=0.0002; RR: 3.50,95% CI 1.81-6.76; P=0.0002, DCR: RR:1.19, 95% CI 1.06-1.32; P=0.002). To date, there is a clinical need of a more efficacious second line of therapy in treatment of the advanced HCC. This study showed some activity of the new targeted therapies in second line of treatment in advanced HCC.
authors.affiliation: Section of Pharmacology and University Center DIFF-Drug Innovation Forward Future, Department of Molecular and Translational Medicine, University of Brescia, Viale Europa 11, 25124 Brescia, Italy; Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100 Cremona, Italy. Electronic address: giandomenicoroviello@gmail.com.
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Roviello
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100 Cremona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Zanotti
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100 Cremona, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Cappelletti
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100 Cremona, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Gobbi
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100 Cremona, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Borsella
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Siena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pacifico
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, Medical Oncology Unit, Siena, Italy.
authors.forename: Andrea Giovanni
authors.initials: AG
authors.lastname: Multari
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100 Cremona, Italy; Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129 Trieste, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
mesh_terms: D000818:Animals; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D058990:Molecular Targeted Therapy; D016032:Randomized Controlled Trials as Topic
keywords: Everolimus; Hepatocellular cancer; Ramucirumab; Second line; Target therapies