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Meta-Analysis
. 2022 Dec 30;101(52):e32207.
doi: 10.1097/MD.0000000000032207.

Efficacy and safety of endostar combined with cisplatin in treatment of non-small cell lung cancer with malignant pleural effusion: A meta-analysis

Yongqi Hu  1 , Zhenke Zhou  1 , Miao Luo  2
Affiliations
Meta-Analysis

Efficacy and safety of endostar combined with cisplatin in treatment of non-small cell lung cancer with malignant pleural effusion: A meta-analysis

Yongqi Hu et al. Medicine (Baltimore). .

Abstract

Background: Although there are new treatments for non-small cell lung cancer with malignant pleural effusion, these therapies are prone to recurrent pleural effusion and poor in efficacy. And recombinant human endostatin is a new type of anti-tumor angiogenesis drug independently developed in my country. It has the effect of inhibiting tumor angiogenesis, inhibiting tumor proliferation and differentiation, and effectively inhibiting the formation and recurrence of malignant pleural effusion. Therefore, this study is aim to systematically review the efficacy and safety of intrapleural injection of endostar combined with cisplatin in the treatment of non-small cell lung cancer (NSCLC) with malignant pleural effusion.

Methods: Databases including Cochrane Library, PubMed, CBM, Embase, CNKI, and WanFang Data were searched to collect randomized controlled trials about endostar combined with cisplatin for NSCLC with malignant pleural effusion from inception to April 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in included studies. Finally, the meta-analysis was made by using RevMan 5.4.1 software.

Results: A total of 11 randomized controlled trials involving 814 patients were finally included. The results of the meta-analysis showed that: The overall response rate and the improvement rate of quality of life in the endostar combined with cisplatin group were higher than that of the cisplatin alone group (relative risk = 1.58, 95% confidence interval = 1.42-1.76, P < .00001; relative risk = 1.63, 95% confidence interval = 1.38-1.93, P < .00001, respectively). Meanwhile, there were no significant differences between the 2 groups in the incidence of gastrointestinal reaction, the incidence of leucopenia, the incidence of thrombocytopenia, and the incidence of hypodynamia (all P values > .05).

Conclusion: Compared with cisplatin, intrapleural injection of endostar combined with cisplatin could improve the overall response rate and the quality of life of NSCLC patients with malignant pleural effusion. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
PRISMA flow chart of selection process to identify studies eligible for pooling.
Figure 2.
Figure 2.
Risk of bias of the included studies—risk of bias graph (A) and summary (B).
Figure 3.
Figure 3.
Forest plot of meta-analysis of the overall response rate. CI = confidence interval, M-H = mantel-haenszel.
Figure 4.
Figure 4.
Forest plot of meta-analysis of quality of life improvement rate. CI = confidence interval, M-H = mantel-haenszel.
Figure 5.
Figure 5.
Forest plot of meta-analysis of the incidence of gastrointestinal reactions. CI = confidence interval, M-H = mantel-haenszel.
Figure 6.
Figure 6.
Forest plot of meta-analysis of the incidence of leukopenia. CI = confidence interval, M-H = mantel-haenszel.
Figure 7.
Figure 7.
Forest plot of meta-analysis of the incidence of thrombocytopenia. CI = confidence interval, M-H = mantel-haenszel.
Figure 8.
Figure 8.
Forest plot of meta-analysis of the incidence of hypodynamia. CI = confidence interval, M-H = mantel-haenszel.
Figure 9.
Figure 9.
The funnel plot of overall response rate. RR = relative risk, SE = standard error.
Figure 10.
Figure 10.
The funnel plot of the rate of improvement in quality of life. RR = relative risk, SE = standard error.
Figure 11.
Figure 11.
The funnel plot of the incidence of gastrointestinal reactions. RR = relative risk, SE = standard error.
Figure 12.
Figure 12.
The funnel plot of the incidence of leukopenia. RR = relative risk, SE = standard error.
Figure 13.
Figure 13.
The funnel plot of the incidence of thrombocytopenia. RR = relative risk, SE = standard error.
Figure 14.
Figure 14.
The funnel plot of the incidence of hypodynamia. RR = relative risk, SE = standard error.
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