Endostar Combined with Chemotherapy versus Chemotherapy alone for Advanced NSCLCs: A Meta-analysis


Background: Use of recombinant human endostatin combined with conventional cytotoxic therapy to treat tumors has been growing because of evidence of increased efficacy. However, whether antiangiogenic therapy combined with chemotherapy really benefits patients with advanced non-small cell lung cancers (NSCLCs) remains unclear.
Objectives: This study was conducted to evaluate the clinical efficacy and safety of rh-endostatin (Endostar) combined with chemotherapy in the treatment of NSCLC patients.
Methods: We selected data from the Cochrane Library, EMBASE, Medline, SCI,CBM, CNKI, to obtain all clinical controlled trials, including the addition of endostar to chemotherapy in advanced NSCLC patients. Twenty-two trials with 1884 patients were included according to the inclusion criteria. All were randomized controlled trials, and four trials were adequate in reporting randomization. Seventeen trials did not mention the blinding methods.
Results: Meta-analysis indicated that the NPE arm (Vinorelbine+ cisplatin+Endostar) had a different response rate compared with NP(Vinorelbine+ cisplatin) arm (OR 2.22, 95%CI 1.62 to 3.03). The incidences of severe leukopenia (OR0.94, 95%CI 0.66 to 1.32) and severe thrombocytopenia (OR 1.00, 95%CI 0.64 to 1.57) and nausea and vomiting (OR 0.85, 95%CI 0.61 to 1.20) were similar in the two arms. There were significant differences between the comparisons of TCE (Paclitaxel + carboplatin + Endostar) versus TC (OR 2.49, 95%CI 1.30 to 4.74) and GPE (Gemcitabine + cisplatin + Endostar) versus GP (OR 2.02, 95%CI 1.11 to 3.68 ) and TPE (Paclitaxel + cisplatin + Endostar) versus TP (OR 2.22, 95%CI 1.32 to 3.75 ).
Conclusions: Our results suggested that in the treatment of advanced NSCLC, endostar in combination with platinum-based chemotherapy could improve the response rate without obviously increasing side effects.