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. 2014;18(1):39-47.
doi: 10.5114/wo.2014.40782. Epub 2014 Feb 28.

The efficacy and safety of thalidomide-based therapy in patients with advanced non-small cell lung cancer: a meta-analysis

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The efficacy and safety of thalidomide-based therapy in patients with advanced non-small cell lung cancer: a meta-analysis

Ying Liu et al. Contemp Oncol (Pozn). 2014.

Abstract

Several randomized controlled clinical trials have compared therapy with or without thalidomide in the treatment of advanced non-small cell lung cancer (NSCLC). However, these studies did not produce consistent results. We carried out a meta-analysis to determine the efficacy and safety of thalidomide-based therapy in patients with advanced NSCLC. For this meta-analysis, we selected randomized clinical trials that compared thalidomide in combination with other therapy or other therapy alone in patients with advanced NSCLC. The outcomes included median overall survival (OS), one- and two-year survival, tumor response, and toxicities. Hazard ratios (HRs) or risk ratios (RRs) were reported with 95% confidence intervals (CIs). A total of 5 eligible trials were included for the meta-analysis, with 729 patients in the thalidomide group and 711 patients in the control group. Compared with non-thalidomide-based therapy, patients receiving thalidomide plus other therapy did not differ significantly in terms of one- and two-year survival or tumor response (RR = 1.32, 95% CI: 0.66-2.63, p = 0.43; RR = 1.22, 95% CI: 0.48-3.11, p = 0.68; RR = 1.05, 95% CI: 0.92-1.19, p = 0.51, respectively). However, thalidomide-based therapy induced more grade 3-4 dizziness and constipation (RR = 2.05, 95% CI: 1.10-3.81, p = 0.02; RR = 4.78, 95% CI: 1.84-12.38, p = 0.001, respectively). The addition of thalidomide to other therapy did not improve survival and tumor response in patients with advanced NSCLC, and thalidomide-based therapy was associated with more grade 3/4 dizziness and constipation.

Keywords: carcinoma; meta-analysis; non-small cell lung; thalidomide.

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Figures

Fig. 1
Fig. 1
Procedures used for trial selection
Fig. 2
Fig. 2
Comparison of overall survival between thalidomide and non-thalidomide based therapy
Fig. 3
Fig. 3
Comparison of two-year survival between thalidomide and non-thalidomide based therapy
Fig. 4
Fig. 4
Comparison of two-year survival between thalidomide and non-thalidomide based therapy
Fig. 5
Fig. 5
Comparison of tumor response between thalidomide and non-thalidomide based therapy
Fig. 6
Fig. 6
Summary of grade 3–4 hematological toxicity
Fig. 7
Fig. 7
Summary of grade 3–4 nonhematological toxicity
Fig. 8
Fig. 8
Funnel plot for comparison of tumor response

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