The Efficacy and Safety of Anlotinib Combination Therapy for Advanced Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

IntroductionAnlotinib, a tyrosine kinase inhibitor, has demonstrated significant anti-tumor activity in hepatocellular carcinoma (HCC); nevertheless, the optimal combination therapy is still contested. Consequently, we synthesized the efficacy and safety of anlotinib in combination therapy for advanced HCC via meta-analysis, offering more extensive data for clinical application.MethodsWe systematically searched PubMed, Embase, Web of Science, and Cochrane Library. The primary efficacy indicators included median overall survival (mOS), median progression-free survival (mPFS), overall response rate (ORR), and disease control rate (DCR). The relevant safety indicators were adverse events (AEs). We conducted a meta-analysis utilizing the STATA 14.0 statistical software.ResultsA total of 14 studies involving 863 patients with HCC were included. The combination therapy with anlotinib showed an ORR of 33.8% (95% confidence intervals (CI): 26.8%-40.7%) and a DCR of 77.1% (95% CI: 70.1%-84.2%). The mPFS and mOS were 6.9 months (95% CI: 6.2-7.6) and 17.1 months (95% CI: 15.6-18.6), respectively. Common AEs associated with anlotinib combination therapy included liver function abnormalities 52.9% (95% CI: 37.7%-68.0%), hand-foot skin reaction 37.2% (95% CI: 26.2%-48.2%), and decreased appetite 32.0% (95% CI: 18.7%-45.3%).ConclusionsAnlotinib-based combination therapy demonstrated promising efficacy with manageable safety in advanced HCC patients.