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Review
. 2020 Nov 10;20(1):548.
doi: 10.1186/s12935-020-01639-4.

A comparison of the efficacy of antiangiogenic agents combined with chemotherapy for the treatment of non-small cell lung cancer: a network meta-analysis

Yimin Li  1 , Yonglin Yi  1 , Anqi Lin  1 , Peng Luo  2 , Jian Zhang  3
Affiliations
Review

A comparison of the efficacy of antiangiogenic agents combined with chemotherapy for the treatment of non-small cell lung cancer: a network meta-analysis

Yimin Li et al. Cancer Cell Int. .

Abstract

Objection: To explore the effects of combinations of antiangiogenic agents and chemotherapy agents on non-small cell lung cancer (NSCLC) patients and indirectly compare the therapeutic effect of Endostar combined with chemotherapy and bevacizumab combined with chemotherapy on NSCLC.

Methods: We searched 3 electronic databases: PubMed, Web of Science and the Cochrane Library. The ORRs, HRs and 95% confidence intervals of OS and PFS were used to compare the efficacy of Endostar combined with chemotherapy and bevacizumab combined with chemotherapy. We use the Bayesian network meta-analysis method to make indirect comparisons and obtain rank probabilities; in addition, we used single-arm meta-analysis to synthesize the existing data.

Results: A total of 29 studies were included in the analysis. Among them, we included a total of 14 interventions. A total of 12,862 patients participated in this analysis. The single-arm meta-analysis showed that the pooled ORR and 95% CI were 0.35 (0.31, 0.39), the pooled HR of OS and 95% CI were 0.89 (0.81, 0.98), and the pooled HR of PFS and 95% CI were 0.67 (0.56, 0.81). According to the results of network meta-analysis, there were no significant differences between the 5 kinds of bevacizumab combined with chemotherapy regimens and the 4 kinds of Endostar combined with chemotherapy regimens for improving ORR and prolonging OS and PFS. The rank probabilities suggested that in terms of ORR, Pla + Pem + Bev was the first-ranked intervention (0.288). Pla + Pem + Endo was the first-ranked intervention for prolonging OS (0.423) and Pla + Gem + Endo was the first-ranked intervention for prolonging PFS (0.302).

Conclusion: Antiangiogenic agents combined with platinum-containing dual drugs can provide benefits to NSCLC patients. In addition, bevacizumab combined with chemotherapy regimens has better theraputic effect on ORR while Endostar combined with chemotherapy may have better effects on OS and PFS for the treatment of NSCLC patients.

Keywords: Antiangiogenic agents; Bevacizumab; Endostar; Network meta-analysis; Non-small cell lung cancer.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flow diagram of the study selection process for the network meta‐analysis
Fig. 2
Fig. 2
Network plot of 14 interventions for the treatment of NSCLC according to Bayesian network meta-analysis. Each node represents a treatment, and the size of the node is proportional to the number of patients. The width of the lines between two nodes represents the number of head‐to‐head trials
Fig. 3
Fig. 3
ORs or HRs between the included interventions according to the results of network meta-analysis (the treatment in the column compared with the treatment in the row)
Fig. 4
Fig. 4
Heat map of the rank probabilities of each intervention according to the results of the network meta-analysis. Figure 3a: ORR. Figure 3b: OS. Figure 3c: PFS. The detailed data are provided in Additional file 1: Table S1
Fig. 5
Fig. 5
Nodesplit analysis and analysis of heterogeneity for ORR, OS and PFS. a1 ~ a3 Nodesplit analysis of ORR. b Nodesplit analysis of OS. C: Nodesplit analysis of PFS. d1 ~ d5 Analysis of heterogeneity for ORR. e1 ~ e4 Analysis of heterogeneity for OS. f1 ~ f4 Analysis of heterogeneity for PFS
Fig. 6
Fig. 6
Single-arm meta-analysis of the ORR of patients treated with antiangiogenic agents combined with chemotherapy
Fig. 7
Fig. 7
Single-arm meta-analysis of the OS and PFS of patients treated with antiangiogenic agents combined with chemotherapy
See this image and copyright information in PMC

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