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The efficacy and safety of platinum plus gemcitabine (PG) chemotherapy with or without molecular targeted agent (MTA) in first-line treatment of non-small cell lung cancer (NSCLC).

ABSTRACT: Trials investigating the efficacy and safety of combining molecular targeted agent (MTA) with platinum-gemcitabine (PG) in first-line treatment of advanced non-small cell lung cancer (NSCLC) have shown inconsistent findings. This meta-analysis aimed to explore whether the addition of MTAs to PG in NSCLC could provide a survival benefit with a tolerable toxicity.Web of knowledge, PubMed, Ovid, Embase, and Cochrane Library were searched to identify relevant studies and extract data on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and common grade 3 or 4 adverse events. Subgroup analyses were conducted on the basis of race and the type of MTA.Twelve trials with a total of 6143 patients were included in this meta-analysis. Compared with PG chemotherapy, combination therapy of MTA with PG did not improve OS (hazard ratio [HR]?=?0.96, 95% confidence interval [CI]?=?0.90-1.01) but improved PFS (HR?=?0.77, 95% CI?=?0.66-0.89) and ORR (risk ratio [RR]?=?1.33, 95% CI?=?1.11-1.60). Subanalysis indicated that there was more incidence of grade 3 or 4 rash (RR?=?11.20, 95% CI?=?6.07-20.68), anemia (RR?=?1.21, 95% CI?=?1.01-1.46), diarrhea (RR?=?2.62, 95% CI?=?1.21-5.65), and anorexia (RR?=?2.08, 95% CI?=?1.12-3.88) in combining epidermal growth factor receptor targeted therapy group compared to PG group. An increased risk of grade 3 or 4 rash (RR?=?5.08, 95% CI?=?1.53-16.79), thrombocytopenia (RR?=?1.50, 95% CI?=?1.03-2.18), and hypertension (RR?=?2.36, 95% CI?=?1.05-5.32) was observed in sorafenib combination group.The combination of PG plus MTA was superior to PG alone in terms of PFS and ORR but not in OS. The combination chemotherapy also showed a higher frequency of grade 3 or higher toxic effects in patients with advanced NSCLC than PG chemotherapy.


PROVIDER: S-EPMC5268042 | BioStudies | 2016-01-01T00:00:00Z

REPOSITORIES: biostudies

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