Objectives The aim of this systematic review is comparing the efficacy and safety of traditional chemotherapy with targeted therapy in managing lung cancer, colorectal cancer (CRC), and hepatocellular carcinoma (HCC). Materials and Methods Article search was conducted on PubMed, Cochrane, Google Scholar, EMBASE, and Web of Science for three weeks, including published or unpublished randomized articles comparing the two treatment modalities in adults. Non-randomized trials or trials comparing one therapy with a placebo or another in the same class were excluded. Eighteen articles were selected and assessed for their bias risk by the Cochrane Collaboration tool, demonstrating a low overall risk of bias. Their methodological quality was evaluated as high by Jadad Scale. Results Results were synthesized narratively, finding that in non-small cell lung cancer (NSCLC), targeted therapy of either afatinib or erlotinib significantly enhanced overall survival (OS) (LUX-Lung 3: p = 0·0015 ; LUX-Lung 6: p = 0·023 ) and progression-free survival (PFS) ( p ), respectively, in comparison to chemotherapy with less incidence of grade 3 or greater adverse events. The efficacy of bevacizumab with chemotherapy showed a contradiction in enhancing OS in two studies conducted in the context of metastatic colorectal cancer (mCRC) with 10% more hypertension and diarrhea occurrence. Targeted therapy of aflibercept and regorafenib showed promising OS ( p = 0.0032 and p = 0.0052 , respectively) and PFS ( p for both agents) results for refractory mCRC. Concerning HCC, sorafenib alone demonstrated OS benefits ( p ), while regorafenib and nivolumab were safe alternatives upon progression. Lenvatinib and pembrolizumab had promising results in unresectable HCC. Conclusion This paper was limited by exempting articles lacking a direct comparison with chemotherapy in HCC and for not conducting a meta-analysis of its results. It suggested validating targeted therapy in NSCLC and investigating gained resistance and optimal sequencing with it.
Namer et al. (Thu,) studied this question.