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Meta-Analysis
. 2016;24(2):117-28.
doi: 10.3727/096504016X14612603423511.

Molecularly Targeted Drugs Plus Radiotherapy and Temozolomide Treatment for Newly Diagnosed Glioblastoma: A Meta-Analysis and Systematic Review

Jiahao Su  1 , Meiqin Cai, Wensheng Li, Bo Hou, Haiyong He, Cong Ling, Tengchao Huang, Huijiao Liu, Ying Guo
Affiliations
Meta-Analysis

Molecularly Targeted Drugs Plus Radiotherapy and Temozolomide Treatment for Newly Diagnosed Glioblastoma: A Meta-Analysis and Systematic Review

Jiahao Su et al. Oncol Res. 2016.

Abstract

Glioblastoma (GBM) is the most common primary malignant brain tumor that nearly always results in a bad prognosis. Temozolomide plus radiotherapy (TEM+RAD) is the most common treatment for newly diagnosed GBM. With the development of molecularly targeted drugs, several clinical trials were reported; however, the efficacy of the treatment remains controversial. So we attempted to measure the dose of the molecularly targeted drug that could improve the prognosis of those patients. The appropriate electronic databases (PubMed, MEDLINE, EMBASE, and the Cochrane Library) were searched for relevant studies. A meta-analysis was performed after determining which studies met the inclusion criteria. Six randomized, controlled trials (RCTs) were identified for this meta-analysis, comprising 2,637 GBM patients. The benefit of overall survival (OS) was hazard ratio (HZ), 0.936 [95% confidence interval (CI), 0.852-1.028]. The benefit with respect to progression-free survival (PFS) rate was HZ of 0.796 (95% CI, 0.701-0.903). OS benefit of cilengitide was HZ of 0.792 (95% CI, 0.642-0.977). The adverse effects higher than grade 3 were 57.7% in the experimental group and 44.1% in the placebo group (odds ratio, 1.679; 95% CI, 1.434-1.967). The addition of molecularly targeted drugs to TEM + RAD did not improve the OS of patients with GBM; however, it did improve PFS in patients treated by cilengitide who could not get improvement in OS. The rate of adverse effects was higher in the experimental group than in the placebo group.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study selection flow chart.
Figure 2
Figure 2
Comparison of OS between the (A) experimental group and the (B) TEM + RAD group.
Figure 3
Figure 3
Comparison of PFS between the (A) experiment group and the (B) TEM + RAD group.
Figure 4
Figure 4
Comparison of PFS of MGMT-methylated patients. (A) Experimental group and (B) TEM + RAD group.
Figure 5
Figure 5
Comparison of OS of MGMT-methylated patients. (A) Experimental group and (B) TEM+RAD group.
Figure 6
Figure 6
Comparison of PFS of MGMT-nonmethylated patients. (A) Experimental group and (B) TEM + RAD group.
Figure 7
Figure 7
Comparison of OS of MGMT-nonmethylated patients. (A) Experimental group and (B) TEM + RAD group.
Figure 8
Figure 8
Comparison of OS and PFS of patients treated by bevacizumab. (a) Comparison of PFS; (b) comparison of OS. (A) Experimental group and (B) TEM+RAD group.
Figure 9
Figure 9
Comparison of OS and PFS of patients treated by cilengitide. (a) Comparison of PFS; (b) comparison of OS. (A) Experimental group and (B) TEM + RAD group.
Figure 10
Figure 10
Comparison of adverse effects. (A) Experimental group and (B) TEM + RAD group.
Figure 11
Figure 11
Funnel plot of PFS between the experimental group and the TEM + RAD group.
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