Efficacy and Safety Profile of Combining Vandetanib with Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer: A Meta-Analysis |
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Authors: | Wei Tian Wenping Ding Sungkyoung Kim Leizhen Zheng Li Zhang Xiaoping Li Jianchun Gu Lian Zhang Minggui Pan Siyu Chen |
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Institution: | 1. Department of oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.; 2. Department of Medical Oncology and Hematology, Kaiser Permanente Medical Center, Santa Clara, California, United States of America.; Shanghai Jiao Tong University School of Medicine, China, |
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Abstract: | ObjectiveTo evaluate the efficacy and safety profile of combining vandetanib with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).MethodsMEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ASCO Abstracts, ESMO Abstracts, Wanfang Database, CNKI were searched. Eligible studies were the randomized clinical trials (RCTs) that compared the efficacy and safety profile of adding vandetanib to chemotherapy with single chemotherapy in patients with advanced NSCLC. The outcomes included overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and toxicities. All meta-analysis were performed using Review Manager 5.1. The fixed-effect model weighted by the Mantel-Haenszel method was used. When considerable heterogeneity was found (p<0.1, or I2>50%), further analysis (subgroup analysis, sensitivity analysis or random-effect model) was performed to identify potential cause.ResultsResults reported from 5 RCTs involving 2284 patients were included in the analysis. Compared to chemotherapy alone, the addition of vandetanib resulted in a significant longer PFS (HR 0.79 0.72–0.87], p<0.00001) and a higher ORR (RR 1.75 1.43–2.15], p<0.00001), but failed to show advantage on OS (HR 0.96 0.87–1.06], p = 0.44).ConclusionVandetanib has activity in NSCLC. Identification of predictive biomarkers is warranted in future trials to select a subset of patients with advanced NSCLC who may benefit from vandetanib. |
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