P-120 Efficacy of systemic therapy for advanced hepatocellular carcinoma based on etiology: A systematic review and network meta-analysis

Emerging data suggested the efficacy of systemic therapy regimen hepatocellular carcinoma (HCC) is affected by disease etiology. However, robust head-to-head comparative lacking, and it less likely to be examined in prospective manner future. Thus, a network meta-analysis helpful compare different agents based on etiology across trials. We aim evaluate survival advanced HCC patients treated with A total five international databases were searched for phase 3 randomized controlled trials (RCTs). included RCTs published from January 2007 November 2022 which evaluated receiving treatments first-line or refractory setting available either one three groups: hepatitis B virus (HBV), C (HCV), non-viral used random-effect pairwise pooled hazard ratios (HRs) 95% confidence intervals (CIs) quantify effect treatments, frequentist (NMA) effectiveness among P-score was rank treatments. Primary outcome overall (OS), while secondary progression-free (PFS). Twenty-three (12 11 setting) included. The 12 encompassed 7776 patients, 4672 patients. For HBV subgroup setting, showed that immunotherapy (pooled HR: 0.67, CI, 0.59-0.76) significantly more effective than targeted 0.93, 0.85-1.02) improving OS (p < 0.0001). NMA indicated Carbozantinib+atezolizumab (P-score: 90%), sintilimab+IBI305 89%), atezolizumab+bevacizumab 88%) yielded best benefits. In both (HR: 0.57, 0.35-0.93) 0.74, CI: 0.65-0.83) OS; regorafenib 81%) pembrolizumab 79%) most regimen. HCV, there trend improved 0.80, 0.55-1.16) 1.17, 0.92-1.48) (p=0.09) no significant difference detected setting. Atezolizumab + bevacizumab 99%) superior regimen, 71%) preferred second-line etiology, between (p=1.00) (p=0.42). Similar trends found analyses PFS HCV infection. improve (p=0.02) (p=0.03). systematic review 23 immunotherapies may viral etiologies. conclusive. Our results inform clinical practice design future