Export file:

Format

  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text

Content

  • Citation Only
  • Citation and Abstract

Apatinib in the treatment of advanced non-small-cell lung cancer: A meta-analysis

1 Department of Thoracic Surgery, Hangzhou Red Cross Hospital, Hangzhou 310003, Zhejiang, China
2 Department of Neurosurgery, The First People’s Hospital of Fuyang Hangzhou, Hangzhou 311400, China

Special Issues: Advanced Big Data Analysis for Precision Medicine

Objectives: The purpose of this meta-analysis was to evaluate the efficacy and toxicity profile of apatinib for the treatment of advanced non-small cell lung cancer (NSCLC). Methods: We systematically searched databases for randomized clinical trials published as of November 25, 2017, in which apatinib treatment was compared to placebo or chemotherapy in patients with advanced NSCLC. Two investigators independently assessed the articles and extracted their data. The hazard ratios (HRs) for progression-free survival (PFS), relative risks (RRs) for overall response rates (ORRs), disease control rates (DCRs), and odds ratios (ORs) for main toxicity were analyzed using the RevMan 5.3 software (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014). Results: Our analysis included 413 patients from 5 clinical studies. The pooled HR for PFS was 0.32 (95% confidence interval (CI) 0.21–0.48; P < 0.00001). The pooled RRs for ORR and DCR were 2.03 (95% CI 1.36–3.01; P = 0.0005) and 1.66 (95% CI 1.07–2.57; P = 0.02), respectively. The pooled OR for main toxicity was 1.34 (95% CI, 0.57–3.17; P = 0.5). Conclusions: Apatinib was a viable treatment alternative for advanced NSCLC, as it offered a clinically meaningful and statistically significant improvement in PFS, ORR, and DCR. Moreover, therapy with apatinib did not significantly increase toxicity.
  Figure/Table
  Supplementary
  Article Metrics

References

1. W. Chen, R. Zheng, P. D. Baade, et al., Cancer statistics in China, 2015, CA Cancer J. Clin., 66 (2016), 115–132.

2. R. L. Siegel, K. D. Miller and A. Jemal, Cancer statistics, 2016, CA Cancer J. Clin., 66 (2016), 7–30.

3. L. A. Torre, R. L. Siegel and A. Jemal, Lung Cancer Statistics, Adv. Exp. Med. Biol., 893 (2016), 1–19.

4. J. Jiang, L. Huang, X. Liang, et al., Gefitinib versus docetaxel in previously treated advanced non-small-cell lung cancer: A meta-analysis of randomized controlled trials, Acta Oncol., 50 (2011), 582–588.

5. N. Li, W. Ou, X. Ye, et al., Pemetrexed-carboplatin adjuvant chemotherapy with or without gefitinib in resected stage IIIA-N2 non-small cell lung cancer harbouring EGFR mutations: A randomized, phase II study, Ann. Surg. Oncol., 21 (2014), 2091–2096.

6. X. Yang, K. Yang and K. Kuang, The efficacy and safety of EGFR inhibitor monotherapy in non-small cell lung cancer: A systematic review, Curr. Oncol. Rep., 16 (2014), 390.

7. C. Zhou, Y. L. Wu, G. Chen, et al., Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): A multicentre, open-label, randomised, phase 3 study, Lancet Oncol., 12 (2011), 735–742.

8. L. V. Sequist, J. C. Yang, N. Yamamoto, et al., Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations, J. Clin. Oncol., 31 (2013), 3327–3334.

9. F. Janku, I. Garrido-Laguna, L. B. Petruzelka, et al., Novel therapeutic targets in non-small cell lung cancer, J. Thorac. Oncol., 6 (2011), 1601–1612.

10. T. Cufer, T. Ovcaricek and M. E. O'Brien, Systemic therapy of advanced non-small cell lung cancer: major-developments of the last 5-years, Eur. J. Cancer, 49 (2013), 1216–1225.

11. Z. Song and Y. Zhang, Retreatment with pemetrexed chemotherapy in advanced non-small cell lung cancer patient, J. Thorac. Dis., 6 (2014), 856–860.

12. B. L. Falcon, S. Chintharlapalli, M. T. Uhlik, et al., Antagonist antibodies to vascular endothelial growth factor receptor 2 (VEGFR-2) as anti-angiogenic agents, Pharmacol. Ther., 164 (2016), 204–225.

13. D. J. Hicklin and L. M. Ellis, Role of the vascular endothelial growth factor pathway in tumor growth and angiogenesis, J. Clin. Oncol., 23 (2005), 1011–1027.

14. J. Li, S. Qin, J. Xu, et al., Randomized, double-blind, placebo-controlled Phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction, J. Clin. Oncol., 34 (2016), 1448–1454.

15. D. Yuan, M. Xia, G. Meng, et al., Anti-angiogenic efficacy of 5'-triphosphate siRNA combining VEGF silencing and RIG-I activation in NSCLCs, Oncotarget, 6 (2015), 29664–29674.

16. J. Li, S. Qin, J. Xu, et al., Apatinib for chemotherapy-refractory advanced metastatic gastric cancer: results from a randomized, placebo-controlled, parallel-arm, phase II trial, J. Clin. Oncol., 31 (2013), 3219–3225.

17. A. Sandler, R. Gray, M. C. Perry, et al., Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer, N. Engl. J. Med., 355 (2006), 2542–2550.

18. M. Reck, J. von Pawel, P. Zatloukal, et al., Phase III trial of cisplatin plus gemcitabine with either placebo or bevacizumab as first-line therapy for nonsquamous non-small-cell lung cancer: AVAil, J. Clin. Oncol., 27 (2009), 1227–1234.

19. X. Hu, J. Zhang, B. Xu, et al., Multicenter phase II study of apatinib, a novel VEGFR inhibitor in heavily pretreated patients with metastatic triple-negative breast cancer, Int. J. Cancer., 135 (2014), 1961–1969.

20. L. Zhang, M. Shi, C. Huang, et al., A phase II, multicenter, placebo-controlled trial of apatinib in patients with advanced nonsquamous non-small cell lung cancer (NSCLC) after two previous treatment regimens, Chin. Soc. Cli. Oncol., 30 (2012).

21. C. M. Faggion, Jr., Evaluating the risk of bias of a study, J. Evid. Based. Dent. Pract., 15 (2015), 164–170.

22. M. K. Parmar, V. Torri and L. Stewart, Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints, Stat. Med., 17 (1998), 2815–2834.

23. J. F. Tierney, L. A. Stewart, D. Ghersi, et al., Practical methods for incorporating summary time-to-event data into meta-analysis, Trials, 8 (2007), 16.

24. E. Zintzaras and J. P. Ioannidis, Heterogeneity testing in meta-analysis of genome searches, Genet. Epidemiol., 28 (2005), 123–137.

25. J. Bi, H. Liu and Y. Huang, Effect of apatinib as single agent on advanced non-small cell lung cancer, J. Clin. Pulm. Med., 22 (2017), 1474–1476..

26. E. Chen, Z. Chen, M. Chen, et al. Clinical effect evaluation of apatinib mesylate tablets in the treatment of advanced non-small cell lung cancer, China. Mod. Med., 24 (2017), 91–93.

27. Y. Guo and X. J. C. J. o. C. O. Jing, Efficacy and safety of docetaxel plus apatinib as a second-line treatment for advanced nonsquamous non-small cell lung cancer, Chin. J. Clin. Oncol., 44 (2017), 544–546.

28. L. Liang and X. Jiang, Progress of apatinib in treatment of non-small cell lung cancer, Cancer Res. Prev. Treat,45 (2018), 928–931.

29. X. Li, C. Zhang, H. Tan, et al., Clinical observation of Apa imatinib mesylate in treatment of advanced non-small cell lung cancer, Chin. J. Bio. Pharm., 2 (2016), 91–93.

30. S. Tian, H. Quan, C. Xie, et al., YN968D1 is a novel and selective inhibitor of vascular endothelial growth factor receptor-2 tyrosine kinase with potent activity in vitro and in vivo, Cancer Sci., 102 (2011), 1374–1380.

31. H. Q. Zhang, F. H. Gong, C. G. Li, et al., Design and discovery of 4-anilinoquinazoline-acylamino derivatives as EGFR and VEGFR-2 dual TK inhibitors, Eur. J. Med. Chem., 109 (2016), 371–379.

32. F. Ghavamipour, S. S. Shahangian, R. H. Sajedi, et al., Development of a highly-potent anti-angiogenic VEGF8-109 heterodimer by directed blocking of its VEGFR-2 binding site, FEBS J., 281 (2014), 4479–4494.

33. Z. Song, X. Yu, G. Lou, et al., Salvage treatment with apatinib for advanced non-small-cell lung cancer, Onco. Targets. Ther., 10 (2017), 1821–1825.

34. J. Xu, X. Liu, S. Yang, et al., Apatinib plus icotinib in treating advanced non-small cell lung cancer after icotinib treatment failure: a retrospective study, Onco. Targets. Ther., 10 (2017), 4989–4995.

35. D. X. Zeng, C. G. Wang, W. Lei, et al., Efficiency of low dosage apatinib in post-first-line treatment of advanced lung adenocarcinoma, Oncotarget, 8 (2017), 66248–66253.

© 2019 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved