Clinical efficacy and safety of sodium cantharidinate plus chemotherapy in non-small-cell lung cancer: A systematic review and meta-analysis of 38 randomized controlled trials

Xiao, Zheng; Wang, Cheng-Qiong; Tan, Zhouke; Hu, Shanshan; Chen, Yali; Zhou, Mengyun; Feng, Jing; Liu, Shiyu; Chen, Ling; Ding, Jie; Gong, Qihai; Tang, Fushan; Liu, Hui; Li, Xiaofei

doi:10.1111/jcpt.12761

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Aidi injection is composed of cantharidin, astragaloside, ginsenoside, elentheroside E, and syringin (Zhang et al, 2012;Zeng et al, 2016). The results from clinical and basic studies revealed that Aidi has an important antitumor, immunoregulatory, anti-inflammatory and antioxidative stress function (Duan et al, 2018b;Li et al, 2018;Zhou et al, 2018;Xiao et al, 2019a;Chen et al, 2019;Farag et al, 2019;Huang et al, 2019;Li et al, 2019;Qu et al, 2019;Zhang et al, 2019). The results of previous SRs/meta-analyses (Ma et al, 2009;Xiao et al, 2016;Wu et al, 2017a;Xiao et al, 2018a;Xiao et al, 2018b;Wang et al, 2018;Xiao et al, 2019b) demonstrated that Aidi in combination with chemotherapy showed significant improvements in tumor response, QOL, and OS rate, and decreases in ADRs.…”

Section: Discussionmentioning

confidence: 99%

The Optimal Adjuvant Strategy of Aidi Injection With Gemcitabine and Cisplatin in Advanced Non–small Cell Lung Cancer: A Meta-analysis of 70 Randomized Controlled Trials

et al. 2021

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Introduction: Aidi injection (Aidi) is composed of cantharidin, astragaloside, ginsenoside, and elentheroside E. As an important adjuvant therapy, Aidi in combination with gemcitabine and cisplatin (GP) is often used in the treatment of non-small cell lung cancer (NSCLC).Objectives: We performed a new evaluation to demonstrate the clinical efficacy and safety of the Aidi and GP combination and further explored an optimal strategy for achieving an ideal response and safety level in advanced NSCLC.Methodology: We collected all the related trials from Chinese and English-language databases, analyzed their methodological bias risk using the Cochrane evaluation Handbook for Systematic Reviews of Interventions Version 5.1.0, extracted all the data using a predefined data extraction form, pooled the data using a series of meta-analyses, and finally summarized the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Results: We included 70 trials with 5,509 patients. Compared with GP alone, the Aidi and GP combination showed a significant improvement in the objective response rate (ORR) [1.82 (1.62–2.04)], disease control rate (DCR) [2.29 (1.97–2.67)], and quality of life (QOL) [3.03 (2.55–3.60)] and a low incidence of hematotoxicity and gastrointestinal and hepatorenal toxicity. Aidi might be more suitable for patients who are first-treated, elderly, or patients with a Karnofsky Performance Status (KPS) score ≥ 60 or anticipated survival time (AST) ≥3 months. An Aidi (50 ml/day, 7–14 days/cycle for one to two cycles), gemcitabine (1000 mg/m2), and cisplatin (20–30 mg/m2, 40–50 mg/m2, or 60–80 mg/m2) might be an optimal regimen for realizing an ideal response and safety level. Most results were robust and of moderate quality.Conclusion: Current evidence indicates that Aidi's value in adjuvant chemotherapy may be broad-spectrum, not just for some regimens. The Aidi and GP combination may show a good short-term response, antitumor immunity, and safety level in patients with NSCLC. Aidi (50 ml/day, 7–14 days/cycle for one and two cycles) with GEM (1000 mg/m2) and DDP (20–30 mg/m2 or 40–50 mg/m2) may be an optimal regimen for realizing an ideal goal in patients who are first-treatment, elderly, or have a KPS score ≥ 60 or AST≥3 months.

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Section: Discussionmentioning

confidence: 99%

The Optimal Adjuvant Strategy of Aidi Injection With Gemcitabine and Cisplatin in Advanced Non–small Cell Lung Cancer: A Meta-analysis of 70 Randomized Controlled Trials

et al. 2021

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“…For instance, SC improved tumor responses and quality of life with reduced risk of hepatotoxicity and gastrointestinal toxicity relative to chemotherapy alone in non-small-cell lung cancer. 18 Moreover, SC possesses the therapeutic ability to lower the expression of S100A3 in hepatocellular carcinoma cells and to induce cellular apoptosis. 19 In the present work, we firstly treated parental and drug resistance cells with SC and provided evidence that SC could remarkably diminish the expression patterns of cancer stem cell markers and spheres formed.…”

Section: Discussionmentioning

confidence: 99%

Combination of Sodium Cantharidinate with Cisplatin Synergistically Hampers Growth of Cervical Cancer

Xiangxun¹,

Zhou²,

Fan³

et al. 2021

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“…Zheng et al. ( 35 ) further conducted a meta-analysis of 38 trials involving 2,845 patients in China, and found that SCA could increase the ORR (1.52 [1.40-1.66]), DCR (1.20 [1.16-1.25]) and QoL (1.76 [1.56-1.98]), but not the 1- and 2-year OS rate (1.16 [0.91-1.47] and 1.21 [0.51-2.91], respectively). Subgroup analysis revealed that SCA was associated with a lower risk of nausea/vomiting, gastrointestinal reactions, neutropenia and thrombocytopenia compared with that of chemotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

“…(35) further conducted a meta-analysis of 38 trials involving 2,845 patients in China, and found that SCA could increase the ORR (1.52 [1.40-1.66]), DCR (1.20 [1.16-1.25]) and QoL (1.76 [1.56-1.98]), but not the 1-and 2-year OS rate (1.16 [0.91-1.47] and 1.21 [0.51-2.91], respectively).…”

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Efficacy and Safety of Docetaxel and Sodium Cantharidinate Combination vs. Either Agent Alone as Second-Line Treatment for Advanced/Metastatic NSCLC With Wild-Type or Unknown EGFR Status: An Open-Label, Randomized Controlled, Prospective, Multi-Center Phase III Trial (Cando-L1)

Deng

Zhang

et al. 2021

Front. Oncol.

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Second-line treatment options for advanced/metastatic non-small cell lung cancer (NSCLC) patients are limited. We aimed to evaluate the efficacy and safety of docetaxel/sodium cantharidinate combination vs. either agent alone as second-line treatment for advanced/metastatic NSCLC patients with wild-type or unknown EGFR status. A randomized, open-label, phase III study was performed at 12 institutions. Patients with failure of first-line platinum regimens were randomized to receive either single-agent sodium cantharivsdinate (SCA) or single-agent docetaxel (DOX) or docetaxel/sodium cantharidinate combination (CON). The primary endpoints were centrally confirmed progression-free survival (PFS) and overall survival (OS). The secondary endpoints were objective response rate (ORR), disease control rate (DCR), quality of life (QoL) and toxicity. A total of 148 patients were enrolled in our study between October 2016 and March 2020. After a median follow-up time of 8.02 months, no significant difference was observed among the three groups in ORR (SCA vs. DOX vs. CON: 6.00% vs. 8.33% vs. 10.00%, respectively; p=0.814) and DCR (74.00% vs. 52.00% vs. 62.50%, respectively; p=0.080). In additional, the mOS was significantly higher in the CON group, compared with the single-agent groups (7.27 vs. 5.03 vs. 9.83 months, respectively; p=0.035), while no significant differences were observed in terms of PFS (2.7 vs. 2.9 vs. 3.1 months, respectively; p=0.740). There was no significant difference in the baseline QoL scores between the three groups (p>0.05); after treatment, life quality in SCA and CON group was significantly better than that in the DOX group (p<0.05). Furthermore, the incidence of adverse events (AEs) in the SCA group was significantly lower (46.00 vs. 79.17 vs. 25.00%, respectively; p=0.038) and the incidence of grade ≥3 AEs was also significantly lower in the SCA group compared with the DOX and CON groups (10.00 vs. 82.00 vs. 30.00%, respectively; p=0.042). Single-agent SCA and single-agent DOX has similar therapeutic efficacy in the second-line treatment of advanced/metastatic NSCLC with wild-type or unknown EGFR status, but single-agent SCA has fewer AEs and better QoL. Also, SCA plus DOX can significantly improve OS and exerted a significant synergistic effect, with good safety and tolerance profile.

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Clinical efficacy and safety of sodium cantharidinate plus chemotherapy in non-small-cell lung cancer: A systematic review and meta-analysis of 38 randomized controlled trials

Abstract: Current evidence reveals that sodium cantharidinate can improve tumour responses and QOL with a lower risk of haematotoxicity and gastrointestinal toxicity than chemotherapy alone in NSCLC. However, the evidence does not indicate that it can improve long-term survival rates.

Cited by 4 publications

References 17 publications

The Optimal Adjuvant Strategy of Aidi Injection With Gemcitabine and Cisplatin in Advanced Non–small Cell Lung Cancer: A Meta-analysis of 70 Randomized Controlled Trials

The Optimal Adjuvant Strategy of Aidi Injection With Gemcitabine and Cisplatin in Advanced Non–small Cell Lung Cancer: A Meta-analysis of 70 Randomized Controlled Trials

Combination of Sodium Cantharidinate with Cisplatin Synergistically Hampers Growth of Cervical Cancer

Efficacy and Safety of Docetaxel and Sodium Cantharidinate Combination vs. Either Agent Alone as Second-Line Treatment for Advanced/Metastatic NSCLC With Wild-Type or Unknown EGFR Status: An Open-Label, Randomized Controlled, Prospective, Multi-Center Phase III Trial (Cando-L1)

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