Efficacy and safety of docetaxel for advanced non-small-cell lung cancer: a meta-analysis of Phase III randomized controlled trials.
Efficacy and safety of docetaxel for advanced non-small-cell lung cancer: a meta-analysis of Phase III randomized controlled trials.
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DOI：
10.2147/ott.s85648
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发表时间：
2015
影响因子：
4
通讯作者：
Li Y
中科院分区：
文献类型：
--
作者：
He X;Wang J;Li Y
一些临床试验对多西他赛和培美曲塞或多西他赛和长春花生物碱进行了风险-收益分析，但疗效和安全性仍不确定。目的是进行一项荟萃分析，比较多西他赛和培美曲塞或多西他赛和长春花生物碱治疗非小细胞肺癌的疗效和安全性。在PubMed、Embase、Cochrane Library和ISI Web of Knowledge检索随机对照试验后，进行了III期随机对照试验的meta分析。结果分析包括总生存期、无进展生存期、总缓解率（95%置信区间）和主要3/4级毒性。7项符合条件的试验涉及2080例患者进行分析。与一线治疗的长春花生物碱相比，多西他赛提高了无进展生存期和总有效率（P<0.05）。然而，多西他赛和培美曲塞作为一线和二线治疗的差异无统计学意义（P < 0.05）。在3/4级毒性方面，与培美曲塞相比，多西他赛导致中性粒细胞减少和发热性中性粒细胞减少增加（P<0.05），但在非血液学毒性方面差异无统计学意义（P<0.05）。多西紫杉醇一线治疗贫血率较低（P<0.05）。与长春花生物碱相比，多西他赛的3/4级血液学和非血液学毒性较低。多西他赛作为一线治疗晚期非小细胞肺癌的有效性和安全性均优于长春花生物碱。与长春花生物碱相比，多西紫杉醇作为二线治疗的毒性也较低。但多西他赛与培美曲塞的疗效和安全性差异不明显。进一步的临床研究，如性别、年龄、组织学等，应考虑说明这两种药物的差异。
Several clinical trials have performed risk–benefit analyses comparing docetaxel and pemetrexed or docetaxel and vinca alkaloid, but the efficacy and safety remain uncertain. The aim was to conduct a meta-analysis to compare the efficacy and safety of docetaxel and pemetrexed or docetaxel and vinca alkaloid for non-small-cell lung cancer. This meta-analysis of Phase III randomized controlled trials was performed after searching PubMed, Embase, the Cochrane Library, and the ISI Web of Knowledge for randomized controlled trials. Outcome analyses were overall survival, progression-free survival, and overall response rate with 95% confidence intervals and major grade 3/4 toxicity. Seven eligible trials involving 2,080 patients were retrieved for analysis. Docetaxel enhanced progression-free survival and overall response rate compared with vinca alkaloid as first-line treatment (P<0.05). However, there was no difference between docetaxel and pemetrexed as both first-line and second-line treatment (P>0.05). With regard to the grade 3/4 toxicity, compared with pemetrexed, docetaxel led to higher neutropenia and febrile neutropenia (P<0.05), but there was no difference in non-hematological toxicity (P>0.05). Docetaxel led to a lower rate of anemia as first-line treatment (P<0.05). Moreover, docetaxel caused less grade 3/4 hematological and non-hematological toxicity compared with vinca alkaloid. Docetaxel leads to a better result than vinca alkaloid in effectiveness and safety on patients with advanced non-small-cell lung cancer as first-line therapy. Docetaxel also causes lower toxicity as second-line therapy compared with vinca alkaloid. However, the differences in efficacy and safety between docetaxel and pemetrexed are not obvious. Further clinical study with more details, such as sex, age, histology, and so on, should be considered for illustrating the differences between these two drugs.