培美曲塞联合铂类双药化疗作为晚期非鳞状非小细胞肺癌一线治疗的疗效：一项系统评价和荟萃分析。

Efficacy of pemetrexed plus platinum doublet chemotherapy as first-line treatment for advanced nonsquamous non-small-cell-lung cancer: a systematic review and meta-analysis.

作者信息

Xiao Huai-Qing, Tian Rong-Hua, Zhang Zhi-Hao, Du Kai-Qi, Ni Yi-Ming

机构信息

Department of Cardiothoracic Surgery, Zhejiang Corps Hospital, Chinese People's Armed Police Force, Jiaxing, Zhejiang Province, People's Republic of China.

Department of Respiratory, Affiliated Haian People's Hospital of Nantong University, Haian, Jiangsu, People's Republic of China.

出版信息

Onco Targets Ther. 2016 Mar 14;9:1471-6. doi: 10.2147/OTT.S96160. eCollection 2016.

PURPOSE

To assess the efficacy of pemetrexed plus platinum doublet chemotherapy as first-line treatment for advanced nonsquamous non-small-cell lung cancer (NSCLC) through a trial-level meta-analysis.

METHODS

Trials published between 1990 and 2015 were identified by an electronic search of public databases (Medline, Embase, and Cochrane Library). All clinical studies were independently identified by two authors. Demographic data, treatment regimens, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were extracted and analyzed using comprehensive meta-analysis software (version 2.0).

RESULTS

A total of 2,551 patients with advanced nonsquamous NSCLC from ten trials were included for analysis: 1,565 patients were treated with pemetrexed plus platinum doublet chemotherapy and 986 with platinum plus other first-line chemotherapy. Pooled ORR for pemetrexed plus platinum chemotherapy was 37.8% (95% confidence interval [CI]: 31.7%-44.3%), with median PFS and OS of 5.7 and 16.05 months, respectively. When compared to other platinum-based doublet chemotherapies, the use of pemetrexed plus platinum chemotherapy significantly improved OS (hazard ratio [HR] =0.86, 95% CI: 0.77-0.97, P=0.01) but not PFS (HR =0.90, 95% CI: 0.80-1.01, P=0.084) in advanced nonsquamous NSCLC patients.

CONCLUSION

Pemetrexed plus platinum doublet regimen is an efficacious treatment for advanced nonsquamous NSCLC patients. Our findings support the use of pemetrexed plus platinum doublet regimen as first-line treatment in advanced nonsquamous NSCLC patients because of its potential survival benefits.

目的

通过一项试验水平的荟萃分析，评估培美曲塞联合铂类双药化疗作为晚期非鳞状非小细胞肺癌（NSCLC）一线治疗的疗效。

方法

通过对公共数据库（Medline、Embase和Cochrane图书馆）进行电子检索，确定1990年至2015年间发表的试验。所有临床研究均由两位作者独立识别。使用综合荟萃分析软件（2.0版）提取并分析人口统计学数据、治疗方案、客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。

结果

共有来自10项试验的2551例晚期非鳞状NSCLC患者纳入分析：1565例患者接受培美曲塞联合铂类双药化疗，986例接受铂类联合其他一线化疗。培美曲塞联合铂类化疗的汇总ORR为37.8%（95%置信区间[CI]：31.7%-44.3%），中位PFS和OS分别为5.7个月和16.05个月。与其他铂类双药化疗相比，在晚期非鳞状NSCLC患者中，使用培美曲塞联合铂类化疗显著改善了OS（风险比[HR]=0.86，95%CI：0.77-0.97，P=0.01），但未改善PFS（HR=0.90，95%CI：0.80-1.01，P=0.084）。