REGORAFENIB FOR SECOND LINE TREATMENT OF PATIENTS WITH ADVANCED, LOW- RISK HEPATOCELLULAR CARCINOMA WITH GOOD PERFORMANCE STATUS: A RAPID REVIEW

Abstract

Introduction: Regorafenib is a protein kinase inhibitor, recommended as a second-line treatment option for advanced or metastatic hepatocellular carcinoma, when patients have good functional capacity and have failed sorafenib. Objective: To evaluate the efficacy and safety of regorafenib for this population through a rapid review. Methods: A rapid review was conducted according to the Cochrane Rapid Reviews Methods Group recommendations. Results: Ten systematic reviews were selected and all of them included the same randomized clinical trial comparing regorafenib to placebo. Thus, the results of the most recent review with network meta- analysis were presented. Among the analyzed interventions, the review showed that all treatments prolonged progression-free survival compared to placebo. For overall survival, only regorafenib (HR, 0.63; 95% CI, 0.5-0.79), cabozantinib (HR, 0.76; 95% CI, 0.63-0.92), ramucirumab (HR, 0.82; 95% CI, 0.7-0.96) and pembrolizumab (HR, 0.79; 95% CI, 0.67-0.93) had a benefit. Regorafenib was superior to the other treatments in gaining overall survival and the second most effective in gaining progression-free survival (p-score of 94.65% and 87.36%, respectively). Conclusion: The selected systematic reviews confirmed the safety and efficacy of regorafenib; however, their network meta-analyses had limited statistical power.