抗血管生成药物联合化疗治疗非小细胞肺癌的疗效比较：一项网状Meta分析

A comparison of the efficacy of antiangiogenic agents combined with chemotherapy for the treatment of non-small cell lung cancer: a network meta-analysis.

作者信息

Li Yimin, Yi Yonglin, Lin Anqi, Luo Peng, Zhang Jian

机构信息

Department of Oncology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, 510282, Guangdong, China.

出版信息

Cancer Cell Int. 2020 Nov 10;20(1):548. doi: 10.1186/s12935-020-01639-4.

OBJECTION

To explore the effects of combinations of antiangiogenic agents and chemotherapy agents on non-small cell lung cancer (NSCLC) patients and indirectly compare the therapeutic effect of Endostar combined with chemotherapy and bevacizumab combined with chemotherapy on NSCLC.

METHODS

We searched 3 electronic databases: PubMed, Web of Science and the Cochrane Library. The ORRs, HRs and 95% confidence intervals of OS and PFS were used to compare the efficacy of Endostar combined with chemotherapy and bevacizumab combined with chemotherapy. We use the Bayesian network meta-analysis method to make indirect comparisons and obtain rank probabilities; in addition, we used single-arm meta-analysis to synthesize the existing data.

RESULTS

A total of 29 studies were included in the analysis. Among them, we included a total of 14 interventions. A total of 12,862 patients participated in this analysis. The single-arm meta-analysis showed that the pooled ORR and 95% CI were 0.35 (0.31, 0.39), the pooled HR of OS and 95% CI were 0.89 (0.81, 0.98), and the pooled HR of PFS and 95% CI were 0.67 (0.56, 0.81). According to the results of network meta-analysis, there were no significant differences between the 5 kinds of bevacizumab combined with chemotherapy regimens and the 4 kinds of Endostar combined with chemotherapy regimens for improving ORR and prolonging OS and PFS. The rank probabilities suggested that in terms of ORR, Pla + Pem + Bev was the first-ranked intervention (0.288). Pla + Pem + Endo was the first-ranked intervention for prolonging OS (0.423) and Pla + Gem + Endo was the first-ranked intervention for prolonging PFS (0.302).

CONCLUSION

Antiangiogenic agents combined with platinum-containing dual drugs can provide benefits to NSCLC patients. In addition, bevacizumab combined with chemotherapy regimens has better theraputic effect on ORR while Endostar combined with chemotherapy may have better effects on OS and PFS for the treatment of NSCLC patients.

目的

探讨抗血管生成药物与化疗药物联合应用对非小细胞肺癌（NSCLC）患者的影响，并间接比较恩度联合化疗与贝伐单抗联合化疗对NSCLC的治疗效果。

方法

检索3个电子数据库：PubMed、Web of Science和Cochrane图书馆。采用客观缓解率（ORR）、风险比（HR）及总生存期（OS）和无进展生存期（PFS）的95%置信区间来比较恩度联合化疗与贝伐单抗联合化疗的疗效。采用贝叶斯网络Meta分析方法进行间接比较并获得排序概率；此外，采用单臂Meta分析对现有数据进行综合分析。

结果

分析共纳入29项研究。其中，共纳入14种干预措施。共有12862例患者参与本分析。单臂Meta分析显示，汇总的ORR及95%置信区间为0.35（0.31，0.39），OS的汇总HR及95%置信区间为0.89（0.81，0.98），PFS的汇总HR及95%置信区间为0.67（0.56，0.81）。根据网络Meta分析结果，5种贝伐单抗联合化疗方案与4种恩度联合化疗方案在提高ORR、延长OS和PFS方面无显著差异。排序概率表明，在ORR方面，培美曲塞+顺铂+贝伐单抗是排名第一的干预措施（0.288）。培美曲塞+顺铂+恩度是延长OS的排名第一的干预措施（0.423），培美曲塞+吉西他滨+恩度是延长PFS的排名第一的干预措施（0.302）。