Please use this identifier to cite or link to this item: https://ninho.inca.gov.br/jspui/handle/123456789/15738
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dc.contributor.authorJácome, Alexandre Andrade dos Anjos-
dc.contributor.authorCastro, Ana Carolina Guimarães de-
dc.contributor.authorVasconcelos, João Paulo Solar-
dc.contributor.authorSilva, Maria Helena-
dc.contributor.authorLessa, Marco Antônio Oliveira-
dc.contributor.authorMoraes, Eduardo Dias de-
dc.contributor.authorAndrade, Aline Cristina-
dc.contributor.authorLima, Frederico-
dc.contributor.authorFarias, João Paulo Fogacci de-
dc.contributor.authorGil, Roberto de Almeida-
dc.contributor.authorProlla, Gabriel-
dc.contributor.authorGaricochea, Bernardo-
dc.date.accessioned2024-04-25T16:37:47Z-
dc.date.available2024-04-25T16:37:47Z-
dc.date.issued2021-
dc.identifier.citationJÁCOME, Alexandre Andrade dos Anjos et al. Efficacy and Safety Associated With Immune Checkpoint Inhibitors in Unresectable Hepatocellular Carcinoma. JAMA Network Open, v. 12, n. 4, p. 1-11, 2021.pt_BR
dc.identifier.urihttps://ninho.inca.gov.br/jspui/handle/123456789/15738-
dc.descriptionp. 1-11.: il. p&b.pt_BR
dc.description.abstractIMPORTANCE Immune checkpoint inhibitors (ICIs) have yielded conflicting results in hepatocellular carcinoma (HCC). The overall effect of ICIs compared with standard therapies in unresectable HCC requires more research. OBJECTIVE To estimate the efficacy and safety associated with ICIs compared with standard therapies in patients with unresectable HCC. DATA SOURCES PubMed, Cochrane Library, Web of Science, Latin American and Caribbean Health Sciences Literature, and American Society of Clinical Oncology and European Society of Medical Oncology meeting proceedings were systematically searched. Reference lists from studies selected by electronic searching were manually searched to identify additional relevant studies. The search included literature published or presented from February 2010 to February 2020. STUDY SELECTION From December 2019 to February 2020, independent reviewers evaluated each database, scanning the title, abstract, and keywords of every record retrieved. Full articles were further assessed if the information given suggested that the study was a randomized clinical trial (RCT) comparing ICIs vs standard therapies in the treatment of unresectable HCC. DATA EXTRACTION AND SYNTHESIS The full text of the resulting studies and extracted data were reviewed independently according to PRISMA guidelines. Summary hazard ratios (HRs) of overall survival (OS) and progression-free survival (PFS) were calculated by a random-effects model. The likelihood of ICIs being associated with overall response rate (ORR) and treatment-related adverse events (TRAEs) was expressed by odds ratios (ORs) using a random-effects model. MAIN OUTCOMES AND MEASURES The main outcomes were OS, PFS, ORR, and TRAEs. RESULTS Of 1836 studies yielded by the search, 3 were retained, totaling 1657 patients (985 treated with ICIs vs 672 receiving standard treatment). Two studies evaluated ICIs as monotherapy, and 1 study investigated the combination of ICIs with bevacizumab. Compared with standard therapies (sorafenib in first-line therapy or placebo in second-line therapy), ICIs were associated with significantly improved OS (HR, 0.75; 95% CI, 0.62-0.92; P = .006), PFS (HR, 0.74; 95% CI, 0.56-0.97; P = .03), and ORR (OR, 2.82; 95% CI 2.02-3.93; P < .001). The probability of grade 3 or 4 TRAEs was lower with ICIs than with sorafenib (OR, 0.44; 95% CI, 0.20-0.96; P = .04). CONCLUSIONS AND RELEVANCE This meta-analysis found superior efficacy and safety associated with ICIs compared with standard therapies and highlights the survival benefit associated with the combination of antiangiogenic therapy with ICIs in first-line systemic therapy of unresectable HCC.pt_BR
dc.language.isoengpt_BR
dc.publisherJAMA Network Openpt_BR
dc.subjectCarcinoma Hepatocelularpt_BR
dc.subjectCarcinoma, Hepatocellularpt_BR
dc.subjectInibidores da Angiogênesept_BR
dc.subjectAngiogenesis Inhibitorspt_BR
dc.subjectInhibidores de la Angiogénesispt_BR
dc.subjectTerapia Neoadjuvantept_BR
dc.subjectNeoadjuvant Therapypt_BR
dc.subjectTerapia Neoadyuvantept_BR
dc.titleEfficacy and safety associated with immune checkpoint inhibitors in unresectable hepatocellular carcinoma: a meta-analysispt_BR
dc.TypeArticlept_BR
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