Abstract
AimsThe role of adoptive immunotherapy (AIT) for patients with hepatocellular carcinoma (HCC) who have received curative therapy is still not well illustrated. This timely meta-analysis aims to update the current evidence on efficacy and safety of AIT for patients with HCC who have received curative therapy.MethodsWe searched PubMed, EMBASE, Scopus and the Cochrane Library Through January 2017 for relevant studies. Mortality and tumor recurrence were compared between patients with or without adjuvant AIT. The meta-analysis was performed using Review Manager 5.3.ResultsEight studies involving 1861 patients met the eligibility criteria and were meta-analyzed. Adjuvant AIT was associated with significantly lower mortality at 1 year (RR 0.64, 95%CI 0.52–0.79), 3 years (RR 0.73, 95%CI 0.65–0.81) and 5 years (RR 0.86, 95%CI 0.79–0.94). Similarly, adjuvant AIT was associated with significantly lower recurrence rate than curative therapies alone at 1 year (RR 0.64, 95%CI 0.49–0.82), 3 years (RR 0.85, 95%CI 0.79–0.91) and 5 years (RR 0.90, 95%CI 0.85–0.95). Short-term outcomes were confirmed in sensitivity analyses based on randomized trials or choice of random- or fixed-effect meta-analysis model. None of the included patients experienced grade 4 adverse events.ConclusionsThis timely meta-analysis confirms the evidence that adjuvant AIT for patients with HCC after curative treatment lowers risk of mortality and tumor recurrence.
Highlights
Hepatocellular carcinoma (HCC) is a common cancer worldwide and ranking as the third most common cause of cancer mortality [1]
Adjuvant adoptive immunotherapy (AIT) was associated with significantly lower mortality at 1 year (RR 0.64, 95%CI 0.52–0.79), 3 years (RR 0.73, 95%CI 0.65–0.81) and 5 years (RR 0.86, 95%CI 0.79–0.94)
Adjuvant AIT was associated with significantly lower recurrence rate than curative therapies alone at 1 year (RR 0.64, 95%CI 0.49–0.82), 3 years (RR 0.85, 95%CI 0.79–0.91) and 5 years (RR 0.90, 95%CI 0.85–0.95)
Summary
Hepatocellular carcinoma (HCC) is a common cancer worldwide and ranking as the third most common cause of cancer mortality [1]. 5-year median disease-free survival after these treatments is only about 37% [4], and 5-year overall survival is about 30% [5]. The poor prognoses of HCC patients highlight the need for effective adjuvant or postoperative treatments that will improve patients’ long-term outcomes [6]. Many types of adjuvant or postoperative treatments for patients with HCC after surgery have been reported [7,8,9,10,11]. No adjuvant or postoperative treatments with definite efficacy is found by previous systematic reviews [12,13] or recommended by official guidelines [3,14]. More systematic review with strict inclusion criteria and comprehensive searching is needed
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