التفاصيل البيبلوغرافية
| العنوان: |
Systematic review with meta‐analysis: the critical role of dermatological events in patients with hepatocellular carcinoma treated with sorafenib. |
| المؤلفون: |
Díaz‐González, Álvaro1, Sanduzzi‐Zamparelli, Marco1, Sapena, Víctor1, Torres, Ferran2, LLarch, Neus1, Iserte, Gemma1, Forner, Alejandro1, da Fonseca, Leonardo1, Ríos, José3,4, Bruix, Jordi1, Reig, María1 MREIG1@clinic.ub.es |
| المصدر: |
Alimentary Pharmacology & Therapeutics. Mar2019, Vol. 49 Issue 5, p482-491. 10p. 1 Diagram, 3 Charts. |
| مصطلحات موضوعية: |
*SORAFENIB, *SKIN disease treatment, *DERMATOLOGY, *SYSTEMATIC reviews, *META-analysis, *LIVER cancer patients |
| مستخلص: |
Summary: Background: The positive results of the REFLECT trial in terms of survival (sorafenib vs lenvatinib) offer a new first‐line option for hepatocellular carcinoma. Additionally, the expected results of immunotherapy could change the first‐line treatment in hepatocellular carcinoma or the clinical trial design in first and second‐line. Aims: To evaluate the impact of dermatologic adverse events under sorafenib in hepatocellular carcinoma patients as a clinical marker to predict prognosis and critically evaluate outcomes within trials. Methods: A systematic search of original articles published until October 2018 was performed using PubMed/MEDLINE and a meta‐analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Results: A total of 393 studies were identified and 13 articles with 2035 patients (79.5% Child‐Pugh‐A, 73.2% BCLC‐C) were selected for qualitative and quantitative analysis. The main type of dermatologic adverse events was hand‐foot skin reaction (47.7%) but other dermatologic adverse events were reported in 31.7% of the cases. Presence of dermatologic adverse events was associated with a lower mortality when compared with those patients without them (pooled Hazard Ratio for the univariate analysis 0.45 (95% CI: 0.38‐0.53) and there was no heterogeneity for the analysis (P = 0.511; I2 = 0.0%). Refuting this association would require the future report of 1370 negative studies. Conclusions: This meta‐analysis shows a clinically meaningful association between dermatologic adverse events and a higher probability of longer survival. These data support the use of dermatologic adverse events in the clinical decision‐making when informing the prognosis and when systemic treatment is decided. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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