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Tang et al. Hepatoma Res 2019;5:19 Hepatoma Research
DOI: 10.20517/2394-5079.2019.07

Meta-Analysis Open Access

Efficacy and safety of immune checkpoint therapy in
hepatocellular carcinoma: meta-analysis

Weina Tang , Long-Teng Ma , Yang Deng , Wei Wang, Hong-Wei Zhang
#
#
#
Department of Epidemiology, Second Military Medical University, Shanghai 200433, China.
# These authors contribute equally to this work.
Correspondence to: Prof. Hong-Wei Zhang, Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd.,
Shanghai 200433, China. E-mail: hwzhang@smmu.edu.cn

How to cite this article: Tang WN, Ma LT, Deng Y, Wei Wang, Zhang HW. Efficacy and safety of immune checkpoint therapy in
hepatocellular carcinoma: meta-analysis. Hepatoma Res 2019;5:19. http://dx.doi.org/10.20517/2394-5079.2019.07

Received: 22 Jan 2019 First Decision: 12 Mar 2019 Revised: 1 Apr 2019 Accepted: 4 Apr 2019 Published: 6 Jun 2019

Science Editor: Guang-Wen Cao Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Aim: Immune checkpoint inhibitors (ICIs) are proven to be an effective way to treat the disease of hematologic
malignancies. But there is still plenty of uncertainty about the effectiveness of ICIs on hepatocellular carcinoma. The
Meta-analysis was conducted to evaluate the efficacy and safety of ICIs treatment in patients with HCC.

Methods: Four electronic databases, including PubMed, Embase, Cochrane database, and ClinicalTrials.gov, were
systematically retrieved for relevant observational studies published before November 1, 2018. The objective
response rate (ORR) and adverse events were analyzed. Meta and Metafor Packages in R were utilized to accomplish
meta proportion analysis.

Results: A total of 462 patients from 7 studies were included in this meta-analysis. The pooled estimated ORR of
ICIs was 19.8% (95% CI 16.4% to 23.7%). No substantial heterogeneity was observed among studies ( Q = 2.0427, P
2
= 0.92, I = 0.0%). The common adverse events on any grade were saw in increased AST (22.7%, 95%CI 13.8% to
35.2%), fatigue (20.9%, 95%CI 10.9% to 36.3%), rash (18.5%, 95%CI 8.9% to 34.4%) and pruritus (17.3%, 95%CI
13.5% to 21.8%). Increased AST (9.9%, 95%CI 4.4% to 21.0%) and increased ALT (5.8%, 95%CI 3.7% to 8.9%)
were the most common adverse events on grade greater than 3.

Conclusion: Although ICIs treatment has a certain efficacy on liver cancer, it also causes some adverse events which
should be noticed by clinicians.

Keywords: Hepatocellular, immune-checkpoint inhibitor, CLAT-4, PD1/PD-L1

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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