Research Papers:
Efficacy and safety of angiogenesis inhibitors in smallcell lung cancer
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Heng Lin1,2,*, Lina Li1,*, Shuimei Luo1, Sijing Zhou1, Ruifen Shen1, Haitao Yang1, Huijuan Chen1, Xianhe Xie1
1Department of Chemotherapy, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
2Department of Oncology, Fuzhou Pulmonary Hospital, Fuzhou, Fujian, China
*These authors have contributed equally to this work
Correspondence to:
Xianhe Xie, email: [email protected]
Keywords: angiogenesis inhibitors, chemotherapy, targeted therapy, small-cell lung cancer, meta-analysis
Received: July 02, 2016 Accepted: November 09, 2016 Published: November 25, 2016
ABSTRACT
Objective: The purpose of this study was to investigate the efficacy and safety of angiogenesis inhibitors for small-cell lung cancer (SCLC).
Methods: Totally, 16 controlled trials (1898 cases) involving angiogenesis inhibitors plus chemotherapy (ACT group) versus chemotherapy alone group (CT group) were identified from PubMed, EMBASE, Cochrane Library and Wanfang Data before March 2016.
Results: Compared with CT group, ACT group obtained a significant benefit on objective response rate (ORR) (RR = 1.34; 95% CI = 1.19-1.51; P < 0.00001) and a trend of prolonging progression-free survival (PFS) (HR = 0.86; 95% CI = 0.73-1.01; P = 0.07) without improving overall survival (OS) (HR = 1.05; 95% CI = 0.94-1.17; P = 0.36). Remarkably, subgroup analysis showed that the antibodies targeting VEGF significantly prolonged PFS (HR = 0.76; 95% CI = 0.64-0.90; P = 0.001). With regard to toxicity, there was no significant difference in severe adverse events (AEs, Grade≥3) between two groups except that gastrointestinal symptom, hypertension, metabolic disorders, neurology and pain were higher in ACT group.
Conclusion: Compared with chemotherapy alone, antibodies targeting VEGF plus chemotherapy significantly improved ORR and prolonged PFS with an acceptable toxicity profile for patients with SCLC. Therefore, angiogenesis inhibitors, especially antibodies targeting VEGF, combining with chemotherapy may be a potential promising strategy in managing SCLC.