Evaluating the efficacy and safety of immunotherapy combinations as first-line treatment for hepatocellular carcinoma: A meta-analysis.

575 Background: Hepatocellular carcinoma (HCC) ranks among the leading causes of cancer-related deaths globally, with limited therapeutic options for patients in advanced stages. Immunotherapy, particularly in combination with other agents, has recently emerged as a promising first-line option. We aim to assess the efficacy and safety of various immunotherapy-based combination regimens in this setting. Methods: We extracted individual patient data (IPD) using Kaplan-Meier curves of published clinical trials from 2018 to 2025. A meta-analysis was conducted to assess the overall survival (OS), progression-free survival (PFS), and all grade adverse events (AEs) among study populations. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: We analyzed data from 3,335 patients, including 878 who received immune checkpoint inhibitors (ICPI) combined with bevacizumab, 728 treated with dual ICPI therapy, and 1,729 who received tyrosine-kinase inhibitor (TKI) alone. The analysis revealed a median OS of 19.09 months (95% CI: 17.09-21.27) in the ICPI+ bevacizumab arm, 19.58 months (95% CI: 17.55-23.32) in the dual ICPI arm, and 15.29 months (95% CI: 13.96-16.27) in the TKI monotherapy arm (p