Efficacy and Safety of Raltitrexed plus Oxaliplatin Transvascular Intervention in the Treatment of Intermediate to Advanced Hepatocellular Carcinoma: A Single-arm Meta-analysis

Abstract

Abstract Background The incidence of primary hepatocellular carcinoma (HCC) has remained high worldwide, and patients with advanced unresectable HCC are not in the minority. Previous studies have shown that oxaliplatin plus raltitrexed via Hepatic Arterial Infusion Chemotherapy(HAIC) can prolong Overall Survival(OS) and Progression-Free Survival(PFS) in patients with advanced HCC. However, almost all studies on this regimen for advanced HCC were non-randomized controlled trials and had all sample sizes, which may lead to a lack of validity of the results obtained. Therefore, the aim of this meta-analysis was to evaluate the efficacy and safety of raltitrexed plus oxaliplatin transvascular intervention in patients with intermediate to advanced HCC. Methods To find relevant studies, we extracted metrics including Overall Remission Rate(ORR), median OS(mOS), median PFS(mPFS), and Adverse Events(AEs) by systematically searching Pubmed, Embase, Cochrane Library and Web of Science data bases for further analysis. Results Seven studies involving 419 patients were finally included. In terms of efficacy against tumors, the ORR across studies combined was 55.9%(95%CI = 46.1%-65.7%), the mPFS and mOS of 5.68 months and 12.47 months. The most common adverse reactions were elevated ALT (incidence: 49.2%, ≥Grade III: 4.6%), abdominal pain (incidence: 47.8%, ≥Grade III: 2.2%) and fever (incidence: 42.9%). The most common adverse event greater than grade 3 was AST elevation, with an incidence of 12.8%. Conclusion The results of this analysis suggested that raltitrexed plus oxaliplatin transvascular intervention has good efficacy and safety in patients with intermediate and advanced HCC, but larger and multicenter clinical trials are still needed to confirm this fact. Registration Information This meta-analysis has completed registration with PROSPERO, the registration number is CRD42023421097.