Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, P. R. China.
Harry Perkins Institute of Medical Research, Centre for Medical Research, University of Western Australia, Nedlands, WA, Australia.
Cancer Med. 2019 Oct;8(13):5930-5938. doi: 10.1002/cam4.2462. Epub 2019 Aug 21.
Small cell lung cancer (SCLC) is a highly invasive and lethal neuroendocrine tumor. Antiangiogenic drugs have been reported in the treatment of SCLC. We aimed to provide a comprehensive evaluation of the impact of angiogenic inhibitors on SCLC survival using network meta-analysis.
The impact of five angiogenesis inhibitors, that is, vandetanib (Van), bevacizumab (Bev), Rh-endostatin (End), sunitinib (Sun), and thalidomide (Tha), on progression-free survival (PFS) and overall survival (OS) was evaluated by conducting a network meta-analysis. RNA sequencing data were downloaded from publicly available databases.
Nine phase II and III randomized controlled trials (RCTs), that involved 1599 participants, that investigated angiogenesis inhibitors in the treatment of SCLC were included in this meta-analysis. Sun and Bev achieved better PFS than Tha (Bev VS. Tha, HR = 0.88, 95% CI: 0.79-0.98, Sun VS. Tha, HR = 0.80, 95% CI: 0.65-1.00). Moreover, Sun and Bev were superior to placebo in terms of PFS (Bev VS. Placebo, HR = 0.89, 95%CI: 0.81-0.97, Sun VS. Placebo, HR = 0.81, 95% CI: 0.66-1.00). Based on this study, we found no significant difference of OS of SCLC. The angiogenesis pathway and expression of target genes were globally deactivated in SCLC tissue.
Results of this network meta-analysis indicate that the PFS outcome of SCLC with Sun or Bev drugs is superior to that of Tha. The improved therapeutic impact of angiogenesis inhibitors on SCLC needs more evidence, such as long-term observation in clinical trials, to be validated.
小细胞肺癌（SCLC）是一种具有高度侵袭性和致命性的神经内分泌肿瘤。已有报道称抗血管生成药物可用于治疗 SCLC。本研究旨在通过网络荟萃分析全面评估血管生成抑制剂对 SCLC 患者生存的影响。
通过网络荟萃分析评估五种血管生成抑制剂（凡德他尼[Van]、贝伐珠单抗[Bev]、恩度[End]、舒尼替尼[Sun]和沙利度胺[Tha]）对无进展生存期（PFS）和总生存期（OS）的影响。从公共数据库下载 RNA 测序数据。
本荟萃分析纳入了 9 项涉及 1599 名参与者的 SCLC 血管生成抑制剂治疗的 II 期和 III 期随机对照试验（RCT）。Sun 和 Bev 较 Tha 具有更好的 PFS（Bev 与 Tha 相比，HR=0.88，95%CI：0.79-0.98，Sun 与 Tha 相比，HR=0.80，95%CI：0.65-1.00）。此外，Sun 和 Bev 在 PFS 方面优于安慰剂（Bev 与安慰剂相比，HR=0.89，95%CI：0.81-0.97，Sun 与安慰剂相比，HR=0.81，95%CI：0.66-1.00）。根据本研究，我们未发现 SCLC OS 存在显著差异。SCLC 组织中的血管生成通路和靶基因表达被全面失活。
本网络荟萃分析结果表明，SCLC 患者接受 Sun 或 Bev 药物治疗的 PFS 结果优于 Tha。需要更多的证据（如临床试验的长期观察）来验证抗血管生成抑制剂对 SCLC 的治疗效果是否得到改善。
