Research Papers:
Combining antiangiogenic therapy with neoadjuvant chemotherapy increases treatment efficacy in stage IIIA (N2) non-small cell lung cancer without increasing adverse effects
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Abstract
Xiaoliang Zhao1,2,3,4, Yanjun Su1,2,3,4, Jian You1,2,3,4, Liqun Gong1,2,3,4, Zhenfa Zhang1,2,3,4, Meng Wang1,2,3,4, Zhenqing Zhao1,2,3,4, Zhen Zhang1,2,3,4, Xiaolin Li1,2,3,4, Changli Wang1,2,3,4
1Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, P.R. China
2Tianjin Lung Cancer Center, Tianjin 300060, P.R China
3Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R China
4National Clinical Research Center for Cancer, Tianjin 300060, P.R China
Correspondence to:
Changli Wang, email: [email protected]
Keywords: recombinant human endostatin, neoadjuvant chemotherapy, non-small cell lung cancer
Received: March 10, 2016 Accepted: August 10, 2016 Published: August 23, 2016
ABSTRACT
To evaluate the safety and efficacy of combining Endostar antiangiogenic therapy with neoadjuvant chemotherapy for the treatment of stage IIIA (N2) NSCLC, we conducted a randomized, controlled, open-label clinical study of 30 NSCLC patients. Patients were randomly assigned to the test or control groups, which received either two cycles of an NP neoadjuvant chemotherapy regimen combined with Endostar or the NP regimen alone, respectively, at a 2:1 ratio. Efficacy was assessed after 3 weeks, and surgical resection occurred within 4 weeks, in the 26 patients who successfully completed treatment. While total response rates (RR) and clinical benefit rates (CBR) did not differ between the experimental groups, total tumor regression rates (TRR) were higher in the test group than in the control group. Median DFS and OS also did not differ between the test and control groups. Clinical perioperative indicators, including intraoperative blood loss, number of dissected lymph node groups, duration of postoperative indwelling catheter use, and time to postoperative discharge, were comparable in the test and control groups. Finally, hematological and non-hematological toxicities and postoperative pathological indicators, including down-staging ratio, complete resection ratio, and metastatic lymph node ratio, also did not differ between the groups. Overall, combining Endostar with NP neoadjuvant chemotherapy increased therapeutic efficacy without increasing adverse effects in stage IIIA-N2 NSCLC patients. This study is registered with ClinicalTrials.gov (number NCT02497118).
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