Department of Pharmacy, Huaihe Hospital of Henan University, Kaifeng, China.
Thorac Cancer. 2018 May;9(5):606-612. doi: 10.1111/1759-7714.12626. Epub 2018 Mar 25.
This meta-analysis was conducted to investigate the efficacy and safety of Endostar (rh-endostatin) versus a placebo in combination with a vinorelbine plus cisplatin (NP) chemotherapy regimen for the treatment of advanced non-small cell lung cancer (NSCLC).
Two reviewers independently searched Medline, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, ASCO, ESMO, the Web of Science, and CNKI databases to locate relevant controlled clinical trials. The treatment efficacy and drug-related toxicity of NP + Endostar (NPE) and NP groups were pooled through meta-analysis according to random or fixed effect models.
Fifteen prospective clinical studies were included in this meta-analysis. The pooled risk ratio (RR) for objective response rate was 1.74 (95% confidence interval [CI] 1.43-2.11); the objective response rate in the NPE group was significantly higher than in the NP group (P < 0.05). Nine publications evaluated the incidence of leucopenia between Endostar versus a placebo in combination with an NP chemotherapy regimen. The pooled results showed no statistically significant difference between NPE and NP chemotherapy regimens for leucopenia, thrombocytopenia, and nausea/vomiting risk (P > 0.05). The one-year survival rate in the NPE group was higher than in the NP group, with a statistically significant difference (RR = 1.70, 95% CI 1.07-2.89; P < 0.05).
Endostar combined with an NP chemotherapy regimen can improve the prognosis of patients with advanced NSCLC without increasing the risk of toxicity.
本荟萃分析旨在研究恩度(重组人血管内皮抑制素)联合长春瑞滨加顺铂(NP)化疗方案与安慰剂联合 NP 化疗方案治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。
两名评审员独立检索 Medline、PubMed、Cochrane 中心对照试验注册库(CENTRAL)、Embase、ASCO、ESMO、Web of Science 和中国知网(CNKI)数据库,以查找相关对照临床试验。根据随机或固定效应模型,对 NP+恩度(NPE)组和 NP 组的治疗疗效和药物相关毒性进行荟萃分析。
本荟萃分析共纳入 15 项前瞻性临床研究。客观缓解率的合并风险比(RR)为 1.74(95%置信区间[CI]1.43-2.11);NPE 组的客观缓解率显著高于 NP 组(P<0.05)。有 9 项研究评估了恩度与 NP 化疗方案联合治疗时白细胞减少的发生率。合并结果显示,NPE 与 NP 化疗方案在白细胞减少、血小板减少和恶心/呕吐风险方面无统计学差异(P>0.05)。NPE 组的 1 年生存率高于 NP 组,差异有统计学意义(RR=1.70,95%CI 1.07-2.89;P<0.05)。
恩度联合 NP 化疗方案可改善晚期 NSCLC 患者的预后,且不增加毒性风险。