{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:13:56Z","timestamp":1783430036317,"version":"3.54.6"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic therapies have been widely applied in the first\u2010line treatment of patients with unresectable hepatocellular carcinoma (uHCC). Regimens based on programmed cell death 1\/ligand 1 (PD\u20101\/PD\u2010L1) inhibitors combined with either bevacizumab or lenvatinib have become first\u2010line treatments, yet the optimal strategy remains controversial. This systematic review and meta\u2010analysis aimed to compare the efficacy and safety of lenvatinib versus bevacizumab, both in combination with PD\u20101\/PD\u2010L1 inhibitors, as first\u2010line therapy for uHCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A thorough literature search was performed in PubMed, Web of Science, Embase, CNKI and Wanfang from their inception to August 1, 2025. The primary endpoints were overall survival (OS) and progression\u2010free survival (PFS), whereas secondary endpoints included objective response rate (ORR), disease control rate (DCR) and adverse events (AEs). A meta\u2010analysis using a random effects model was performed to obtain hazard ratio (HRs) and 95% confidence intervals. Statistical analyses were conducted using Stata software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 10 retrospective cohort studies involving 1659 patients were included. The analysis demonstrated that, compared with the bevacizumab\u2010based regimen, the lenvatinib\u2010based regimen was associated with significantly prolonged OS (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200955.9%, HR: 0.69, 95% CI: 0.5\u20130.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) and PFS (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200945.7%, HR: 0.73, 95% CI: 0.59\u20130.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). No significant differences were observed between the two groups in terms of ORR (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200965%, RR: 1.09, 95% CI: 0.91\u20131.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.304) or DCR (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200977%, RR: 0.99, 95% CI: 0.92\u20131.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.532). Regarding safety, the overall incidence of AEs was comparable between the two groups. However, the lenvatinib\u2010based regimen was associated with a higher incidence of hand\u2010foot skin reaction and neutropenia, whereas the bevacizumab\u2010based regimen carried a higher risk of gastrointestinal haemorrhage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this meta\u2010analysis of retrospective studies, lenvatinib plus PD\u20101\/PD\u2010L1 inhibitor regimens were associated with superior OS and PFS compared with bevacizumab plus PD\u20101\/PD\u2010L1 inhibitor regimens as first\u2010line regimen for uHCC in East Asian populations. These findings require confirmation in large\u2010scale, prospective, multinational randomized controlled trials in other populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70647","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:32:16Z","timestamp":1776663136000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lenvatinib Versus Bevacizumab in Combination With Anti\u2010\n                    <scp>PD<\/scp>\n                    \u20101\/\n                    <scp>PD<\/scp>\n                    \u2010\n                    <scp>L1<\/scp>\n                    Therapy for\n                    <scp>uHCC<\/scp>\n                    : A Meta\u2010Analysis of East Asian 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