Clinical Report: Efficacy and Safety Comparison of First-Line Therapies for Advanced HCC

Overview

This meta-analysis evaluates the efficacy and safety of first-line treatments for advanced hepatocellular carcinoma (HCC), highlighting the superiority of hepatic arterial infusion chemotherapy (HAIC) and selected immunotherapy combinations. The findings suggest significant survival benefits without increased severe adverse events.

Background

Advanced hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with a poor prognosis and limited treatment options historically dominated by sorafenib. The emergence of combination therapies, including HAIC and immunotherapy, presents new opportunities for improving patient outcomes. Understanding the comparative effectiveness of these therapies is crucial for optimizing treatment strategies.

Data Highlights

Key Findings

• HAIC-based regimens, particularly sorafenib plus HAIC, ranked highest for overall survival (OS) and progression-free survival (PFS).
• Immunotherapy combinations demonstrated significant survival benefits across various clinical subgroups.
• Subgroup analyses indicated consistent benefits across age, sex, macrovascular invasion, and ECOG performance status.
• Grade ≥ 3 adverse events were not significantly increased with immunotherapy combinations.
• The findings support the need for future head-to-head trials to refine treatment strategies.

Clinical Implications

Clinicians should consider HAIC-based strategies and selected immunotherapy combinations as first-line treatments for advanced HCC due to their superior survival outcomes. Ongoing evaluation of treatment efficacy and safety is essential as new therapies emerge.

Conclusion

HAIC and selected immunotherapy combinations represent promising first-line options for advanced HCC, warranting further investigation to optimize treatment protocols.

Related Resources & Content

1. Author(s)/Org, Source, Year -- Title
2. Mohamad Bassam Sonbol, MD, The ASCO Post, 2020 -- Meta-analysis of Outcomes With Systemic Therapy in First- and Second-Line Treatments of Advanced HCC
3. Celsa et al, The ASCO Post, 2025 -- Which First-Line Systemic Therapy Balances Survival and Quality of Life in Advanced Hepatocellular Carcinoma?
4. EASL Clinical Practice Guidelines, ScienceDirect, 2025 -- EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma
5. Frontiers in Oncology — Evaluating the efficacy and safety of first-line immunotherapy for metastatic triple-negative breast cancer: a systematic review and network meta-analysis of randomized controlled trials with a focus on PD-L1 expression
6. EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma - ScienceDirect
7. Depth and Duration of Response Are Associated with Survival in Patients with Unresectable Hepatocellular Carcinoma: Exploratory Analyses of IMbrave150 - PubMed
8. Integrating Quality of Life and Survival in Systemic Therapy for Advanced Hepatocellular Carcinoma