The impact of histological types on the efficacy of angiogenesis inhibitors in the treatment of advanced NSCLC: a meta-analysis of randomized controlled trials
The impact of histological types on the efficacy of angiogenesis inhibitors in the treatment of advanced NSCLC: a meta-analysis of randomized controlled trials
复制标题
组织学类型对血管生成抑制剂治疗晚期 NSCLC 疗效的影响：随机对照试验的荟萃分析
作者：
Jian Zhang;Jie Liu;Hui;Weibing Wu;Xiaojun Li;Yonghui Wu;Kai Zhang;L. Gu
目的评价含血管生成抑制剂（AI）方案治疗不同组织学类型的晚期非小细胞肺癌（NSCLC）的疗效。方法检索PubMed和Web of Science中的研究，以及截至2014年10月31日在美国临床肿瘤学会（ASCO）会议上发表的摘要，以确定相关研究。符合条件的研究包括前瞻性随机对照试验（RCT），根据患者的组织学评估晚期NSCLC中的AI和生存数据。终点为总生存期（OS）和无进展生存期（PFS）。根据纳入研究的异质性，采用随机效应或固定效应模型进行统计分析。结果13项随机对照试验共纳入10,035例晚期非小细胞肺癌患者。汇总结果表明，与不含AI的方案相比，含AI的方案显著改善了肺腺癌的PFS（HR，0.84，95%置信区间（CI）：0.78-0.91，P<0.001）和OS（HR，0.92，95% CI：0.85-0.99，P=0.017）。此外，在鳞状细胞肺癌中，含AI方案的PFS显著改善（HR，0.87，95% CI：0.77-0.98，P=0.027），但未转化为OS获益（HR，1.02，95% CI：0.92-1.15，P=0.68）。对于其他组织学类型的NSCLC患者，使用AI未显著改善PFS（HR，0.90，95% CI：0.75-1.09，P=0.27）和OS（HR，0.90，95% CI：0.76-1.08，P=0.19）。结论本研究的结果表明，在肺腺癌患者的治疗方案中加入AI可提高生存率。建议进行前瞻性临床试验，调查AI在这种情况下的作用。
Purpose We aimed at assessing the overall efficacy of angiogenesis inhibitor (AI)-containing regimens in the treatment of advanced non-small-cell lung cancer (NSCLC) according to histological types. Methods Studies from PubMed and Web of Science, and abstracts presented at American Society of Clinical Oncology (ASCO) meeting up to October 31, 2014 were searched to identify relevant studies. Eligible studies included prospective randomized controlled trials (RCTs) evaluating AIs in advanced NSCLC with survival data according to patients’ histologies. The endpoints were overall survival (OS) and progression-free survival (PFS). Statistical analyses were conducted by using either random effects or fixed effect models according to the heterogeneity of included studies. Results A total of 10,035 patients with advanced NSCLC from 13 RCTs were identified for analysis. The pooled results demonstrated that AI-containing regimens significantly improved the PFS (HR, 0.84, 95% confidence interval (CI): 0.78–0.91, P<0.001) and OS (HR, 0.92, 95% CI: 0.85–0.99, P=0.017) in lung adenocarcinoma when compared to non-AI-containing regimens. Additionally, there was a significantly improved PFS (HR, 0.87, 95% CI: 0.77–0.98, P=0.027) for AI-containing regimens in squamous cell lung carcinoma, but it did not translated into OS benefit (HR, 1.02, 95% CI: 0.92–1.15, P=0.68). For NSCLC patients with other histological types, the use of AIs did not significantly improve PFS (HR, 0.90, 95% CI: 0.75–1.09, P=0.27) and OS (HR, 0.90, 95% CI: 0.76–1.08, P=0.19). Conclusion The findings of this study suggest that the addition of AIs to the treatment therapies for patients with lung adenocarcinoma offers improved survival benefits. Prospective clinical trials investigating the role of AIs in this setting are recommended.
DOI：
10.1016/s1470-2045(10)70132-7
发表时间：
2010-07
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Herbst RS;Sun Y;Eberhardt WE;Germonpré P;Saijo N;Zhou C;Wang J;Li L;Kabbinavar F;Ichinose Y;Qin S;Zhang L;Biesma B;Heymach JV;Langmuir P;Kennedy SJ;Tada H;Johnson BE
通讯作者：
Johnson BE
影响因子：
158.5
作者：
Sandler, Alan;Gray, Robert;Johnson, David H.
通讯作者：
Johnson, David H.