Summary

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• This summary is based on the review of 62 systematic review(s)/meta-analysis(es). ^[1-62]
• In hepatocellular carcinoma (HCC), Hepatic artery infusion chemotherapy with oxaliplatin plus fluorouracil (HAIC-FO) demonstrated notable effectiveness in improving overall survival (OS), particularly in patients with macrovascular invasion (MVI) and extrahepatic spread (EHS), showing the highest effectiveness in this subgroup (Surface Under the Cumulative Ranking Curve (SUCRA) = 0.99). HAIC-FO also achieved superior progression-free survival (PFS) and objective response rate (ORR) compared to anti-vascular endothelial growth factor tyrosine kinase inhibitors (VEGF-TKI) and immune checkpoint inhibitor monotherapies.
• For renal cell carcinoma (RCC), lenvatinib combined with pembrolizumab presented enhanced OS and PFS benefits, especially for intermediate- and poor-risk patients, with robust evidence from the CLEAR trial showing superiority over sunitinib. The combination was also linked to the highest likelihood of improved ORR compared to other treatments, including nivolumab plus cabozantinib.
• In endometrial cancer, lenvatinib plus pembrolizumab yielded a median OS ranging from 17.2 months to an undefined upper limit, with a median PFS of up to 258 days and a pooled ORR of 32.7%. Enhanced response rates were noted in the dMMR group compared to the pMMR group, indicating potential subgroup benefits.
• For thyroid cancer, lenvatinib demonstrated significant OS and PFS improvements in patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC) compared to placebo, underscoring its efficacy in this specific cancer type.
• In HCC, lenvatinib was frequently associated with hypertension and proteinuria but had a lower incidence of hand-foot-skin reactions compared to sorafenib.
• In RCC and endometrial cancer, lenvatinib combined with pembrolizumab showed a high incidence of adverse events, with 80.2% of patients experiencing grade ≥3 events. For endometrial cancer specifically, the pooled proportions of any-grade and grade ≥3 adverse events were 95.8% and 80.2%, respectively.
• In adenoid cystic carcinoma (ACC), lenvatinib treatment led to notable rates of grade ≥3 adverse events, particularly hypertension and proteinuria.
• For medullary thyroid cancer, lenvatinib and other tyrosine kinase inhibitors (TKIs) commonly led to grade ≥3 adverse events, including hypertension, decreased appetite, rash, and lymphopenia, highlighting the frequent occurrence of serious side effects across different cancer types treated with lenvatinib.
• In HCC, tremelimumab combined with durvalumab showed the greatest efficacy in Asian populations (SUCRA = 0.88).
• For RCC, lenvatinib combined with pembrolizumab showed numerical overall survival improvement in intermediate- to poor-risk patients. In endometrial cancer, patients with deficient mismatch repair (dMMR) exhibited higher objective response and disease control rates compared to those with proficient mismatch repair (pMMR).