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Meta-Analysis
. 2021 Dec;12(23):3208-3215.
doi: 10.1111/1759-7714.14188. Epub 2021 Oct 21.

Endostar (rh-endostatin) improves efficacy of concurrent chemoradiotherapy for locally advanced non-small cell lung cancer: A systematic review and meta-analysis

Meng Yuan #  1 , Yirui Zhai #  1 , Yu Men  1   2 , Jianyang Wang  1 , Lei Deng  1 , Wenqing Wang  1 , Yongxing Bao  1 , Xu Yang  1 , Shuang Sun  1 , Zeliang Ma  1 , Yunsong Liu  1 , Jun Wang  3 , Hui Zhu  4 , Zhouguang Hui  1   2
Affiliations
Meta-Analysis

Endostar (rh-endostatin) improves efficacy of concurrent chemoradiotherapy for locally advanced non-small cell lung cancer: A systematic review and meta-analysis

Meng Yuan et al. Thorac Cancer. 2021 Dec.

Abstract

Background: We aimed to clarify the benefits of the addition of rh-endostatin into concurrent chemoradiotherapy (CCRT) versus CCRT alone for locally advanced non-small cell lung cancer (NSCLC) by a meta-analysis.

Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials, Wanfang and Chinese National Knowledge Infrastructure (CNKI) were systematically screened from inception to November 2020 using the prespecified terms. Prospective trials (evaluating or) comparing the efficacy of endostar combined with CCRT and CCRT for locally advanced NSCLC were included. The primary endpoints were risk ratios (RRs) for objective response rate (ORR) and disease control rate (DCR). The secondary endpoints were RRs for overall survival (OS) and adverse events (AEs).

Results: Ten studies with 716 patients were included in this meta-analysis. Endostar combined with CCRT significantly improved ORR and DCR compared with CCRT. The RRs of ORR and DCR for endostar combined with CCRT versus CCRT were 1.263 (95% CI: 1.137-1.403, p < 0.001) and 1.274 (95% CI: 1.124-1.444, p < 0.001), respectively. Endostar combined with CCRT significantly improved one-year survival rate compared with CCRT with pooled RR = 1.113 (95% CI: 1.006-1.231, p = 0.038). Endostar combination treatments had similar incidences of main adverse events compared with CCRT (p > 0.05).

Conclusion: Endostar combined with CCRT is associated with significantly higher ORR, DCR and survival rate than CCRT with similar incidences of main adverse events in NSCLC.

Keywords: NSCLC; chemoradiotherapy; endostar; meta-analysis.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript.

Figures

FIGURE 1
FIGURE 1
Literature search / PRISMA flow chart
FIGURE 2
FIGURE 2
(a) Forest plot of objective response rate for endostar combined with CCRT versus CCRT. (b) Forest plot of disease control rate for endostar combined with CCRT versus CCRT. (c) Forest plot of 1‐year survival rate for endostar combined with CCRT versus CCRT. RR, risk ratio; CI, confidence interval; CCRT, concurrent chemoradiotherapy
FIGURE 3
FIGURE 3
(a) Forest plot of radiation‐induced pneumonitis for endostar combined with CCRT versus CCRT. (b) Forest plot of radiation esophagitis for endostar combined with CCRT versus CCRT. (c) Forest plot of leukopenia for endostar combined with CCRT versus CCRT. RR, risk ratio; CI, confidence interval; CCRT, concurrent chemoradiotherapy
FIGURE 4
FIGURE 4
Funnel plot of the objective response rate for endostar combined with CCRT versus CCRT. CCRT, concurrent chemoradiotherapy
See this image and copyright information in PMC

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