{
  "abstract": "Background: The triplet combination of hepatic arterial infusion chemotherapy (HAIC), a tyrosine kinase inhibitor (TKI), and a programmed cell death-1 (PD-1) inhibitor has emerged as a highly promising strategy for unresectable hepatocellular carcinoma (uHCC). This study aimed to comprehensively evaluate the efficacy and safety of this triple-therapy compared with the dual-therapy of a TKI plus a PD-1 inhibitor.\n\nMethods: We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials or comparative cohort studies that assessed HAIC plus a TKI and a PD-1 inhibitor (H-T-P) versus a TKI plus a PD-1 inhibitor (T-P) for uHCC. The primary endpoints were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). The secondary endpoint was treatment-related adverse events (AEs). A random-effects model was employed to pool data, calculating hazard ratios (HRs) or relative risks (RRs) with their 95% confidence intervals (CIs).\n\nResults: A total of 12 studies involving 2,386 patients with uHCC were included. Compared with T-P dual therapy, the H-T-P triple therapy was associated with significantly improved OS (HR, 0.51; 95%CI, 0.47-0.56; P < 0.001) and PFS (HR, 0.59; 95%CI, 0.51-0.68; P < 0.001). Furthermore, the H-T-P group demonstrated a significantly higher ORR (RR, 1.97; 95%CI, 1.73-2.24; P < 0.001) and DCR (RR, 1.19; 95%CI, 1.11-1.28; P < 0.001). Regarding safety, while no significant difference was observed in the overall incidence of all-grade AEs ( P = 0.238), the incidence of grade ≥3 AEs was significantly higher in the triple-therapy arm (RR, 1.29; 95%CI, 1.13-1.48; P = 0.004), consisting primarily of manageable hepatotoxicity and hematologic toxicities.\n\nConclusion: Our findings indicate that for patients with uHCC, the H-T-P triple-therapy regimen is superior to dual therapy in terms of survival benefits and tumor response. The associated increase in severe toxicity is considered predictable and clinically manageable.\n\nSystematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420251113276.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hepatobiliary Surgery, Loudi Central Hospital",
    "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Hunan University of Medicine",
    "Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University",
    "Department of General Surgery, The People’s Hospital of Liangping District",
    "Department of Gynecologic Oncology, Chongqing University Cancer Hospital",
    "Department of General Surgery, University-Town Hospital of Chongqing Medical University",
    "Department of Gastroenterology and Hepatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine",
    "Department of Hematology and Oncology, The First Affiliated Hospital of Hunan University of Medicine"
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Renbin Ouyang"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Xiaocheng Li"
    },
    {
      "affs": [
        3
      ],
      "name": "Kun Huang"
    },
    {
      "affs": [
        4
      ],
      "name": "Duke Chen"
    },
    {
      "affs": [
        5
      ],
      "name": "Yaowei Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xinmin Li"
    },
    {
      "affs": [
        6
      ],
      "name": "Liming Zhu"
    },
    {
      "affs": [
        7
      ],
      "name": "Chunzhi Liang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3c6g2h9hx9eat.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1896692",
  "fulltext_url": "https://europepmc.org/articles/PMC13686884",
  "id": "3c6g2h9hx9eat",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1896692/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2721|Hepatocellular Carcinoma Treatment and Prognosis"
    ]
  ],
  "openalex": "W7220905076",
  "pdf_url": "https://europepmc.org/articles/PMC13686884?pdf=render",
  "pmcid": "PMC13686884",
  "pmid": "42923097",
  "published": "2026-10-08",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/3c6g2h9hx9eat.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1896692",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1896692/full"
    },
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42923097",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923097"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2234-943X",
      "subfield": "oncology"
    }
  ],
  "title": "Efficacy and safety of hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors and PD-1 inhibitors for unresectable hepatocellular carcinoma: a meta-analysis",
  "title_text": "Efficacy and safety of hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors and PD-1 inhibitors for unresectable hepatocellular carcinoma: a meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/3c6g2h9hx9eat",
  "venue": "Frontiers in Oncology",
  "versions": []
}