The Efficacy of Combining Antiangiogenic Agents with Chemotherapy for Patients with Advanced Non-Small Cell Lung Cancer Who Failed First-Line Chemotherapy: A Systematic Review and Meta-Analysis |
| |
Authors: | Jin Sheng Yunpeng Yang Yuxiang Ma Bijun Yang Yaxiong Zhang Shiyang Kang Ting Zhou Shaodong Hong Tao Qin Zhihuang Hu Wenfeng Fang Yan Huang Li Zhang |
| |
Affiliation: | 1. Department of Medical Oncology of Sun Yat-sen University Cancer Center, Guangzhou, China.; 2. State Key Laboratory of Oncology in South China, Guangzhou, China.; 3. Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.; 4. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.; Catalan Institute of Oncology, SPAIN, |
| |
Abstract: | BackgroundThe clinical outcomes of patients with NSCLC who progressed after first-line treatments remain poor. The purpose of this study was to assess the advantage of antiangiogenic therapy plus standard treatment versus standard treatment alone for this population of patients.MethodsWe conducted a rigorous search using electronic databases for eligible studies reporting antiangiogenic therapy combined with standard second-line chemotherapy versus standard second-line treatment for patient who progressed after front-line treatment. Pooled risk ratio and 95% confidence intervals were calculated using proper statistical method. Predefined subgroup analyses were conducted to identify the potential proper patients.ResultsThirteen phase II/III RCTs which involved a total of 8358 participants were included. Overall, there was significant improvement in OS (HR 0.94, 95%CI: 0.89-0.99, p=0.03), PFS (HR 0.80, 95%CI: 0.76-0.84, p<0.00001), ORR (RR 1.75, 95%CI: 1.55-1.98, p<0.00001) and DCR (RR 1.23, 95%CI: 1.18-1.28, p<0.00001) in the group with antiangiogenic therapy plus standard treatment versus the group with standard treatment alone. Subgroup analysis showed that OS benefit was presented only in patients treated with docetaxel plus antiangiogenic agents (HR 0.92, 95%CI: 0.86-0.99, p=0.02) and patients with non-squamous NSCLC (HR for OS 0.92, 95%CI: 0.86-0.99, p=0.02).ConclusionsThis study revealed that the addition of antiangiogenic agents to the standard treatments could provide clinical benefit to NSCLC patients who failed their first-line therapy. Furthermore, proper selection of the combined standard cytotoxic agent, as well as the patient population by tumor histology, is warranted for future studies and clinical application of antiangiogenic therapy. |
| |
Keywords: | |
|
|