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Efficacy and safety of angiogenesis inhibitors in advanced non-small cell lung cancer: a systematic review and meta-analysis

  • Original Article - Clinical Oncology
  • Published:
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Abstract

Purpose

Vascular endothelial growth factor signaling pathway plays a crucial role in angiogenesis and has become a promising target for cancer drug development. We aimed to quantify the overall efficacy and safety of angiogenesis inhibitors in advanced non-small cell lung cancer (NSCLC).

Methods

Electronic databases were searched for randomized controlled trials (RCTs) comparing angiogenesis inhibitors with non-angiogenesis inhibitors for NSCLC patients. The extracted data on objective response rates (ORRs), disease control rates (DCRs), progression-free survival (PFS) and overall survival (OS) were pooled. Common adverse events (AEs) were also studied.

Results

A total of 33 RCTs involving 17,396 patients were included. Compared with non-angiogenesis inhibitors, angiogenesis inhibitors resulted in significant improvement in PFS (HR, 0.81; 95 % CI 0.76–0.85; p < 0.001), OS (HR, 0.95; 95 % CI 0.92–0.98; p = 0.004), ORR (RR, 1.54; 95 % CI 1.37–1.73; p < 0.001) and DCR (RR, 1.18; 95 % CI 1.10–1.27; p < 0.001). The AEs associated with angiogenesis inhibitors were generally predictable and manageable.

Conclusion

Angiogenesis inhibitors were superior to non-angiogenesis inhibitors in terms of ORR, DCR, PFS and OS in advanced NSCLC patients. Further studies are warranted to explore the predictive biomarkers to pick up those who may gain utmost benefit from anti-angiogenic therapy.

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Acknowledgments

We received fund support from Wu Jieping Medical Foundation Project (Grant No: 08-JC-003), Innovative drug R&D center based on real-time high-throughput cell-based screening platform and large capacity compound library (Grant No: 2013ZX09401003-002), National Natural Science Funds of China (Grant No: 81372502) and National High Technology Research and Development Program of China (Grant No: 2012AA02A502).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Medical Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, People’s Republic of China

    Shaodong Hong & Li Zhang

  2. State Key Laboratory of Oncology in South China, Guangzhou, China

    Shaodong Hong & Li Zhang

  3. Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

    Shaodong Hong & Li Zhang

  4. Medical School, Sun Yat-sen University, Guangzhou, China

    Min Tan, Shouzheng Wang & Shengyuan Luo

  5. Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China

    Shouzheng Wang

  6. Medical School, University of South China, Hengyang, Hunan, China

    Yue Chen

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  1. Shaodong Hong
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  2. Min Tan
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  3. Shouzheng Wang
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  4. Shengyuan Luo
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  6. Li Zhang
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Corresponding author

Correspondence to Li Zhang.

Additional information

S. Hong, M. Tan and S. Wang are contributed equally to this article and share the first authorship.

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Supplementary material 1

Sensitivity meta-analyses for (A) progression-free survival (PFS), (B) overall survival (OS), (C) objective response rate (ORR) and (D) disease control rate (DCR) by sequentially omitting individual trial. (PDF 372 kb)

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Hong, S., Tan, M., Wang, S. et al. Efficacy and safety of angiogenesis inhibitors in advanced non-small cell lung cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol 141, 909–921 (2015). https://doi.org/10.1007/s00432-014-1862-5

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  • DOI: https://doi.org/10.1007/s00432-014-1862-5

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