Single-agent maintenance therapy in non-small cell lung cancer： a systematic review and meta-analysis

• Published in: Chinese medical journal Vol. 125; no. 17; pp. 3143 - 3149
• Main Authors: Yuan, Dong-Mei, Wei, Shu-Zhen, Lü, Yan-Ling, Zhang, Yan, Miao, Xiao-Hui, Zhan, Ping, Yu, Li-Ke, Shi, Yi, Song, Yong
• Format: Journal Article
• Language: English
• Published: China Department of Respiratory Medicine,Jinling Hospital,Nanjing University School of Medicine,Nanjing,Jiangsu 210002,China%Department of Respiratory Medicine,Nanjing Chest Hospital,Nanjing,Jiangsu 210029,China 05.09.2012
• Subjects: Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Disease-Free Survival; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Publication Bias; 单药; 毒副反应; 治疗; 系统; 评价; 试验比较; 随机对照试验; 非小细胞肺癌; non-small cell lung cancer; meta-analysis; maintenance therapy; molecular targeted therapy; systematic review
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2012.17.032

Background Can single-agent maintenance therapy be considered as an ideal strategy for non-small cell lung cancer （NSCLC） treatment to achieve prolonged survival and tolerated toxicity？ A systematic review and meta-analysis was performed to etuc（date this issue. Methods The electronic databases were searched for RCTs comparing single-agent maintenance therapy with placebo, best support care or observation. The required data for estimation of response, survival and toxicity were extracted from the publications and the combined data were calculated. Results Eleven RCTs involving 3686 patients were identified. We found a statistically significant higher probability of tumor response for patients with maintenance therapy versus control patients （OR： 2.80, 95% CI： 2.15-3.64）. Patients receiving maintenance therapy had significantly longer progression-free survival （PFS） （HR： 0.67, 95% CI： 0.62-0.71） and overall survival （OS） （HR： 0.84, 95% CI： 0.78-0.90）. However, maintenance therapy was associated with more severe toxicities （OR： 6.45, 95% CI： 4.61-9.01）. Conclusion In patients with advanced NSCLC, the use of single-agent maintenance therapy is associated with higher response rate and significantly prolongs PFS and OS despite of the risk of additional toxicity.