EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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 ISSN 2394-3211

Impact Factor: 6.222

 ICV - 79.57

Abstract

EFFICACY OF TARGETED THERAPY IN UNSELECTED PATIENTS WITH ADVANCED NON-SMALL-CELL LUNG CANCER: A NETWORK META-ANALYSIS

Miaomiao Sheng, Fang Wang, Yueguang Zhao, Shanshan Li, Xiaojie Wang, Tao Shou, Ying Luo, Wenru Tang*

ABSTRACT

Objective: Currently, targeted therapy has shown encouraging treatment benefits in selected patients with advanced non-small cell lung cancer (NSCLC). However, the comparative benefits of targeted drugs and chemotherapy treatments in unselected patients are not clear. We therefore conducted a network meta-analysis to assess the relative efficacy of these regimens. Methods: We searched Pubmed, EMBASE, Cochrane Library and abstracts from major scientific meetings for eligible literatures. The hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) was used for pooling effect sizes. Bayesian network meta-analysis was conducted to calculate the efficacy of all included treatments. All tests of statistical significance were two sided. Results: A total of 18476 patients from 32 randomized controlled trials (RCT) were assessed. The targeted therapy included bevacizumab (Bev), gefitinib (Gef), erlotinib (Erl) and cetuximab (Cet). Network meta-analysis showed that Bev+chemotherapy (CT) was associated with statistically significant hazard ratio for PFS relative to Gef (HR, 0.73; 95% CI, 0.55-0.96), Erl (HR, 0.64; 95% CI, 0.47-0.83), CT (HR, 0.69; 95% CI, 0.55-0.84) and placebo (HR, 0.49; 95% CI, 0.34-0.67). No statistically significant differences were observed for combination therapy treatments, including Erl+CT, Gef+CT, Bev+CT, Cet+CT and Bev+Erl. Trend analyses of rank probability revealed that Bev+CT and Bev+Erl were among the top ranked for PFS, Cet+CT was most probable to be the rank 1 in terms of OS and followed by Bev+CT. Conclusions: Our study suggested that Bev+CT may offer greater benefits in the treatment of unselected patients with advanced NSCLC. Cet+CT presented the best survival but inferior PFS compared with Bev+CT.

Keywords: non-small-cell lung cancer, targeted drugs, efficacy, network meta-analysis.


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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing