AIT improves mortality, recurrence in HCC patients after curative treatment
Adjuvant adoptive immunotherapy (AIT) for hepatocellular carcinoma (HCC) patients who have received therapy is both safe and effective for improving mortality rates and tumour recurrence, a new meta-analysis shows.
The Cochrane Library, Scopus, EMBASE and PubMed were searched for studies that investigated the effects of adjuvant AIT on HCC patients after curative treatments compared with either no interventions or control interventions. Those that considered advanced, unresectable or recurrent HCC were excluded.
The Newcastle-Ottawa and the Jadad scales were used to assess the quality of the non-randomized and observational trials, and randomized trials, respectively.
After applying the inclusion and exclusion criteria, eight studies (seven randomized controlled trials [RCT], one cohort study), corresponding to 949 treated and 912 untreated individuals, were included. Four of the RCTs had high methodological quality while three had low scores. The cohort study had a low risk of bias.
A fixed-effects model showed that, compared with curative therapies alone, adjuvant AIT was associated with improved mortality rates at 1 year (risk ratio [RR], 0.63; 95 percent CI, 0.50 to 0.78; p<0.001), 2 years (RR, 0.72; 0.63 to 0.83; p<0.001), 3 years (RR, 0.74; 0.65 to 0.83; p<0.001) and 5 years (RR, 0.88; 0.80 to 0.96; p=0.005).
Similarly, adjuvant AIT was associated with improvements in tumour recurrence rates at 1 year (RR, 0.80; 0.71 to 0.90; p=0.001), 2 years (RR, 0.80; 0.70 to 0.83; p<0.001), 3 years (RR, 0.86; 0.80 to 0.90; p<0.001) and 5 years (RR, 0.91; 0.85 to 0.97; p=0.004).
Finally, no serious adverse events or deaths were documented across the eight studies included. The most common adverse events were chills and fever. Tachycardia, itching, dizziness, myalgia, fatigue, nausea and headaches were also observed.