Table 1.
Basic characteristics and quality assessment of the included studies.
| Study | Design | Treatment | Patients | Age, years | Sex, M/F | HBV, P/N | Child–Pugh, A/B | AFP (ng/ml), <400/≥400 | MVI, yes/no | Extrahepatic metastasis, yes/no | BCLC stage, A/B/C | CR, N (%) | ORR, N (%) | DCR, N (%) | Median PFS, months | Median OS, months | Quality |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dai 2021 | R single center | TACE + Sor + sintilimab | 35 | 56.5 ± 10.2 | 30/5 | 27/8 | 19/16 | NA | 17/18 | 6/29 | 0/14/21 | 6 (17) | 10 (29) | 28 (80) | 5 | 13 | H |
| Sor + sintilimab | 23 | 54.0 ± 15.0 | 21/2 | 18/5 | 12/11 | NA | 16/7 | 5/18 | 0/5/18 | 4 (17) | 6 (26) | 17 (74) | 4 | 9 | |||
| Mei 2021 | R single center | HAIC + Len+ ICIs | 45 | 49.1 ± 10.6 | 38/7 | 37/8 | 44/1 | 4,106.0 (72.8–121,000.0) | 36/9 | 15/30 | 0/5/40 | 0 (0) | 18 (40) | 38 (84) | 8.8 | 15.9 | H |
| Len + ICIs | 25 | 50.1 ± 12.3 | 18/7 | 19/6 | 22/3 | 767.6 (23.3–21,940.5) | 18/7 | 13/12 | 0/3/22 | 0 (0) | 4 (14) | 11 (44) | 5.4 | 8.6 | |||
| Chen 2021 | R multi-center | HAIC + Len + pembrolizumab | 84 | 52 (42–67) | 72/12 | 45/39 | 71/13 | 3,984.0 (82.0–49,534.0) | 49/35 | 20/64 | 0/22/62 | 13 (15) | 50 (60) | 74 (88) | 10.9 | 17.7 | H |
| Len + pembrolizumab | 86 | 53 (43–69) | 71/15 | 48/38 | 75/11 | 4,022.0 (79.0–51,462.0) | 55/31 | 24/62 | 0/21/65 | 8 (9) | 36 (42) | 71 (83) | 6.8 | 12.6 | |||
| Guo 2022 | R single center | cTACE+ MTDs + camrelizumab | 31 | 24/7 <60/≥60 |
26/5 | 29/2 | 21/10 | 17/14 | 20/11 | 17/14 | 2/5/24 | 2 (6) | 16 (52) | 28 (90) | 11.7 | 19.8 | H |
| MTDs + camrelizumab | 23 | 12/11 <60/≥60 |
22/1 | 20/3 | 14/9 | 12/11 | 11/12 | 14/9 | 1/3/19 | 0 (0) | 5 (22) | 15 (65) | 4 | 11.6 | |||
| Huang 2022 after PSM | R single center | TACE + immune-targeted therapy | 24 | 58.0 ± 10.7 | 20/4 | 20/4 | 18/6 | 12/12 | 18/6 | 9/15 | 0/0/24 | 1 (4) | 10 (42) | 19 (79) | 7.4 | 17.3 | H |
| Immune-targeted therapy | 24 | 56.5 ± 14.0 | 21/3 | 20/4 | 14/10 | 9/15 | 18/6 | 13/11 | 0/0/24 | 0 (0) | 3 (13) | 12 (50) | 6.7 | 11.8 | |||
| Dong 2022 | R dual center | TACE/HAIC + immune-targeted therapy | 66 | 52 (40–65) | 57/9 | 54/12 | 50/16 | 39/27 | 25/41 | 29/37 | 0/0/66 | 2 (3) | 40 (61) | 56 (85) | 8.4 | 11.6 | H |
| Immune-targeted therapy + TACE/HAIC | 56 | 52 (41–64) | 51/5 | 52/4 | 42/14 | 28/28 | 27/29 | 29/27 | 0/0/56 | 0 (0) | 18 (32) | 42 (75) | 5.3 | 10.0 | |||
| Immune-targeted therapy | 41 | 57 (47–67) | 34/7 | 36/5 | 31/10 | 20/21 | 16/25 | 24/17 | 0/0/41 | 0 (0) | 9 (22) | 33 (80) | 6.3 | 11.3 | |||
| Wang 2023 after PSM | R single center | TACE + Len + ICIs | 43 | 57.07 ± 10.53 | 38/5 | 42/4 | 39/4 | 25/18 | 19/24 | 22/21 | 0/8/35 | 0 (0) | 24 (56) | 37 (86) | 10.2 | 20.5 | H |
| Len + ICIs | 43 | 58.00 ± 10.52 | 37/6 | 52/7 | 36/7 | 21/22 | 18/25 | 25/18 | 0/7/36 | 0 (0) | 13 (30) | 28 (65) | 7.4 | 12.6 | |||
| Xin 2023 | R single center | TACE + Len + ICIs | 60 | 37/23 <60/≥60 |
54/6 | 56/4 | 60/0 | 32/28 | 28/32 | 18/42 | 0/21/39 | 10 (17) | 46 (77) | 58 (97) | 16.2 | 29 | H |
| Len + ICIs | 58 | 40/18 <60/≥60 |
51/7 | 51/7 | 58/0 | 28/30 | 17/41 | 26/32 | 0/23/35 | 3 (5) | 26 (45) | 44 (76) | 10.2 | 17.8 | |||
| Yang 2023 after PSM |
R single center | TACE + regorafenib + ICIs | 23 | 53 (43.0–65.0) | 20/3 | 19/4 | 22/1 | 15/8 | 8/15 | 11/12 | 0/19/14 | 0 (0) | 8 (35) | 16 (70) | 5.8 | 13.6 | H |
| Regorafenib + ICIs | 23 | 49 (45.0–56.0) | 19/4 | 16/7 | 18/5 | 14/9 | 10/13 | 12/11 | 0/5/18 | 0 (0) | 1 (4) | 10 (44) | 2.6 | 7.5 | |||
| Fu 2023 | R single center | HAIC + Len + ICIs | 89 | 51.9 ± 10.5 | 83/6 | 79/10 | 88/1 | 37/52 | 89/0 | 21/68 | 0/0/89 | 17 (19) | 55 (62) | 77 (87) | 11.5 | 26.3 | M |
| Len + ICIs | 53 | 53.5 ± 10.5 | 50/3 | 45/8 | 47/6 | 20/33 | 53/0 | 26/27 | 0/0/53 | 2 (4) | 11 (21) | 30 (57) | 5.5 | 13.8 | |||
| Pan 2023 after PSM | R multicenter | TACE/HAIC + immune-targeted therapy | 131 | 54.0 (48.5–61.0) | 118/13 | 117/14 | 127/4 | 20,461.84 ± 36,365.99 | 102/29 | 48/83 | 0/19/112 | 2 (2) | 48 (37) | 112 (85) | NA | 23.9 | H |
| Immune-targeted therapy | 131 | 54.0 (47.5–60.5) | 119/12 | 112/19 | 122/9 | 20,331.47 ± 85,642.76 | 83/48 | 48/83 | 0/19/112 | 6 (5) | 43 (33) | 109 (83) | NA | Not reached | |||
| Lang 2023 after PSM | R single center | TACE + Len + sintilimab | 75 | 57/18 ≤60/>60 |
66/9 | 69/6 | 59/16 | 45/30 | 23/52 | 26/49 | 0/32/43 | 2 (3) | 33 (44) | 47 (63) | 11.1 | Not reached | H |
| Len+ sintilimab | 39 | 29/10 ≤60/>60 |
34/5 | 35/4 | 30/9 | 23/16 | 9/30 | 19/20 | 0/14/25 | 0 (0) | 9 (23) | 17 (44) | 5.1 | 14.0 | |||
| Li 2023 | R multicenter | TACE + immune-targeted therapy | 62 | 50/12 <65/≥65 |
55/7 | 46/16 | 48/13/1 A/B/C |
24/38 | 28/34 | 14/48 | 6/9/46/1 A/B/C/D |
NA | N | NA | 7.4 | 20.3 | M |
| Immune-targeted therapy | 83 | 46/37 <65/≥65 |
71/12 | 58/35 | 65/17/1 A/B/C |
43/40 | 43/40 | 32/51 | 6/8/68/1 A/B/C/D |
NA | NA | NA | 5.0 | 13.6 | |||
| Hu 2023 | R single center | TACE + immune-targeted therapy | 98 | 52 (42–62) | 87/11 | 85/13 | 75/23 | 39/59 ≤200/>200 |
73/25 | 49/49 | 0/12/86 | 22 (22) | 73 (74) | 89 (91) | 9.7 | 19.5 | H |
| Immune-targeted therapy | 49 | 53 (47–63) | 47/2 | 43/6 | 33/16 | 22/27 ≤200/>200 |
30/19 | 26/23 | 0/7/42 | 4 (8) | 20 (41) | 36 (73) | 7.7 | 10.8 | |||
| Cao 2023 | R dual center | TACE + Atez/Bev | 62 | 55.8 ± 11.2 | 52/10 | 44/18 | 40/22 | 30/32 | 34/28 | 33/29 | NA | 1 (2) | 24 (39) | 43 (69) | 10 | 14 | H |
| Atez/Bev | 77 | 52.8 ± 11.0 | 65/12 | 59/18 | 51/26 | 41/36 | 43/34 | 45/32 | NA | 1 (1) | 13 (17) | 49 (64) | 6 | 10 | |||
| Jin 2024 after sIPTW | R multicenter | TACE + immune-targeted therapy | 805 | 54 (48–63) | 693/112 | 681/124 | 659/146 | 394/354 | 570/235 | 471/334 | NA | NA | 332 (41.2) | NA | 9.9 | 22.6 | H |
| Immune-targeted therapy | 437 | 56 (47–62) | 378/59 | 374/63 | 357/80 | 208/197 | 308/129 | 258/179 | NA | NA | 100 (22.9) | NA | 7.4 | 15.9 |
TACE, transcatheter arterial chemoembolization; HAIC, hepatic artery infusion chemotherapy; MTDs, molecularly targeted drugs; ICIs, immune checkpoint inhibitors; Len, lenvatinib; Sor, sorafenib; Atez, atezolizumab; Bev, bevacizumab; R, retrospective; M, male; F, female; HBV, hepatitis B virus; P, positive; N, negative; S, single; M, multiple; MVI, macrovascular invasion; BCLC, Barcelona Clinic Liver Cancer stage; CR, complete response; PR, partial response; ORR, objective response rate; DCR, disease control rate; OS, overall survival; PFS, progression-free survival; H, high; M, medium; NA, not available; PSM, propensity score matching; sIPTW, stabilized inverse probability of treatment weighting.