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Zhongguo Fei Ai Za Zhi = Chinese... May 2011In recent years, there has been a large number of studies and reports about the efficacy and safety of recombinant human endostatin (rh-endostatin), an anti-angiogenic... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
In recent years, there has been a large number of studies and reports about the efficacy and safety of recombinant human endostatin (rh-endostatin), an anti-angiogenic drug, in treatment of advanced lung cancer. Authentic assessment of rh-endostatin treatment in lung cancer is important. The aim of this study is to assess the clinical efficacy and safety of rh-endostatin combined with chemotherapy in the treatment of patients with non-small cell lung cancer (NSCLC).
METHODS
Cochrane systematic review methods were used in the data selection, and data were selected from the Cochrane Library, EMBASE, Medline, SCI, CBM, CNKI, and etc electronic database to get all clinical controlled trials. The retrieval time was March 2010. The objects of these randomized controlled trials were advanced NSCLC patients and in the experimental group was rh-endostatin combination chemotherapy, in the control group was chemotherapy alone to compare the efficacy of two groups. The quality of included trials were evaluated by two reviewers independently. The software RevMan 5.0 was used for meta-analyses.
RESULTS
Fifteen trials with 1,326 patients were included according to the including criterion. All trials were randomized controlled trials, and two trials were adequate in reporting randomization. Thirteen trials didn't mention the blinding methods. Meta analysis indicated that the NPE arm (Vinorelbine+cisplatin+rh-endostatin) had a different response rate compared with NP (Vinorelbine+cisplatin) arm (OR=2.16, 95%CI: 1.57-2.99). The incidences of severe leukopenia (OR=0.94, 95%CI: 0.66-1.32) and severe thrombocytopenia (OR=1.00, 95%CI: 0.64-1.57) and nausea and vomiting (OR=0.85, 95%CI: 0.61-1.20) were similar in the NPE arm compared with those in the NP arm. The NPE plus radiotherapy (RT) arm had a similar response rate compared with NP plus RT arm (OR=2.39, 95%CI: 0.99-5.79). The incidences of leukopenia (OR=0.83, 95%CI: 0.35-1.94) and thrombocytopenia (OR=0.78, 95%CI: 0.19-3.16) and radiation esophagitis (OR=1.00, 95%CI: 0.40-2.49) were similar in the NPE plus RT arm compared with those in the NP plus RT arm.
CONCLUSION
In the treatment of advanced NSCLC, rh-endostatin in combination with platinum-based chemotherapy improve the response rate without obviously raised side effects, however, when radiotherapy are added to NPE arm or NP arm, the response rates have a similar outcome. Owing to the small sample size and poor quality of included trials, more well-designed double-blinded randomized controlled trials should be performed.
Topics: Antineoplastic Agents; Carcinoma, Non-Small-Cell Lung; Drug-Related Side Effects and Adverse Reactions; Endostatins; Humans; Lung Neoplasms; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 21569645
DOI: 10.3779/j.issn.1009-3419.2011.05.05 -
Zhongguo Fei Ai Za Zhi = Chinese... Mar 2009In the past years, many reports on Kanglaite were publicated in China, researchers across the country. The aim of this study is to review the effectiveness and safety of...
BACKGROUND
In the past years, many reports on Kanglaite were publicated in China, researchers across the country. The aim of this study is to review the effectiveness and safety of Kanglaite for treating advanced non-small-cell lung cancer.
METHODS
Authors searched the Cochrane Library, Pubmed, Embase, Cancerlit, CBM, CNKI and VIP. Mannual and additional search were also conducted. All randomized controlled trials/quasi-RCT comparing Kanglaite with other lung cancer treatment were included. Two reviewers independently performed data extraction and appraised the publications using the Juni instrument, disagreements were resolved by consensus. Double data were entered and analyzed by RevMan 4.2 software are by Cochrane Collaboration.
RESULTS
Sixteen reports were included in the meta-analysis. The quality of 16 studies was low. Pooling data of 5 studies indicated that the effect of Kanglaite+NP (Vinorelbine+Cisplatin) was better than NP with RR 1.46, 95% Confidence Interval 1.13 to 1.91. Pooling data of 3 studies of MVP (Mitomycin+Vindsine+ Cisplatin) plus Kanglaite indicated that the effect was better with RR 1.84, 95%CI 1.22 to 2.76. Pooling data of 2 studies showed that the effect of GP (Gemcitabine+Cisplatin) plus Kanglaite was better than GP with RR 1.63, 95%CI 1.09 to 2.43. Fourteen studies revealed that Kanglaite may reduce the side-effect induced by regular treatment. Ten studies showed regular treatment plus Kanglaite can stabilite/improve quality of life.
CONCLUSIONS
Kanglaite can enhance clinical effect of regular treatment, reduce side-effect and stabilite/improve quality of life, but the effect of Kanglaite being used in clinical settings needs to be confirmed by further large and multicenter.
PubMed: 20716423
DOI: 10.3779/j.issn.1009-3419.2009.03.018 -
Lung Cancer (Amsterdam, Netherlands) Sep 2005Hitherto, platinum-based combinations are world-wide accepted regimens in the treatment of advanced non-small cell lung cancer (NSCLC) due to a clear survival... (Meta-Analysis)
Meta-Analysis
Hitherto, platinum-based combinations are world-wide accepted regimens in the treatment of advanced non-small cell lung cancer (NSCLC) due to a clear survival improvement using various platinum-based doublets in comparison with best supportive care only. However, treatment-allocated time and period with high grade toxicity could be considered as wasted from the patient point of view and the high toxicity induced by platinum-based doublets urges the research of alternate treatments. Newest cytotoxic compounds as so-called third generation drugs (i.e. vinorelbine, docetaxel, paclitaxel and gemcitabine) yield a better efficacy/toxicity ratio. Platinum-free doublet regimens based on these new drugs are expected to offer the patients an improved survival without decreasing his quality of life. Recent update of ASCO guidelines recommended that "for stage IV NSCLC, [...] non-platinum-containing chemotherapy regimens may be used as alternatives to platinum-based regimens in the first line." In spite of this recommendation, the case of non-platinum containing regimen is still debatable and this review deals with methodological statements highlighted by the reports of 14 recently reported randomised studies comparing non-platinum with platinum-based doublets (174 words).
Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Clinical Trials as Topic; Clinical Trials, Phase III as Topic; Databases, Bibliographic; Deoxycytidine; Docetaxel; Humans; Lung Neoplasms; Paclitaxel; Platinum Compounds; Quality Control; Randomized Controlled Trials as Topic; Taxoids; Treatment Outcome; Vinblastine; Vinorelbine; Gemcitabine
PubMed: 15913840
DOI: 10.1016/j.lungcan.2005.03.034