Efficacy and safety of recombinant human endostatin combined with radiotherapy or chemoradiotherapy in patients with locally advanced non-small cell lung cancer: a pooled analysis

Abstract

Purpose: To assess the efficacy and safety of recombinant human endostatin in combination with radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC). Methods: We searched eligible literature in available databases using combinations of the following search terms: lung cancer, endostatin or endostar, radiotherapy or radiation therapy or chemoradiotherapy. The inclusion criteria were: prospective or retrospective (including single-arm) studies that evaluated the efficacy and safety of endostatin plus radiotherapy (ERT) or concurrent chemoradiotherapy (ECRT) in patients with LA-NSCLC. Primary outcomes included the following: objective response rate (ORR), local control rates (LCR), overall survival (OS), progression-free survival (PFS), and adverse events (AEs). Tests of heterogeneity, sensitivity, and publication bias were performed. Results: A total of 271 patients with LA-NSCLC from 7 studies were enrolled, including six prospective trials and one retrospective study. The pooled median PFS was 11.3 months overall, 11.2 months in the ECRT group, and 11.8 months in the ERT group. Pooled median OS and ORR were 18.9 months and 77.2% overall, 18.4 months and 77.5% in the ECRT group, and 19.6 months and 76.1% in the ERT group, respectively. The incidences of major grade ≥ 3 AEs for all patients, subgroups of ECRT and ERT were 10.9% vs 11.9% vs 9.4% for radiation pneumonitis, 11.6% vs 12.2% vs 9.4% for radiation esophagitis, 35.5% vs 43.4% vs 0 for leukopenia, 27.8% vs 40.7% vs 2.1% for neutropenia, and 10.5% vs 12.3% vs 2.1% for anemia. Conclusions: Combined endostatin with RT or CCRT is effective and well tolerated in treating LA-NSCLC, and less toxicities occur. Further validation through prospective randomized control trials is required.

The Efficacy and Safety of Continuous Intravenous Endostar Treatment Combined With Concurrent Chemoradiotherapy in Patients With Locally Advanced Cervical Squamous Cell Carcinoma: A Randomized Controlled Trial

“…In terms of the safety, we found that Endostar plus CCRT was an independent risk factor for neutropenia and infection. Similarly, it was once reported that a higher incidence of neutropenia occurred in locally advanced NSCLC when combined with Endostar (23). The high frequency of infection could be due to neutropenia, as there is a potential connection between AEs.…”

Efficacy of concurrent chemoradiotherapy plus Endostar compared with concurrent chemoradiotherapy in the treatment of locally advanced nasopharyngeal carcinoma: a retrospective study

“…The incidence of grade 3 or 4 leukopenia in CCRT + E is highly variable across studies, ranging from 5.3 to 44.8% [15,[34][35][36], which may be related to different chemotherapy regimens and cycles, Endostar cycles, and radiotherapy doses. In this study, the incidence of grade 3/4 leukopenia in the CCRT + E group was 32.6%, but all patients recovered with symptomatic management, and no patient interrupted or discontinued treatment, and no patient died of acute toxic events.…”

Systematic Evaluation Meta-Analysis of the Efficacy of Recombinant Human Endostatin Combined with Gemcitabine and Cisplatin in Non-Small-Cell Lung Cancer

“…e standard treatment is 4-6 cycles of platinum combined with the third generation of cytotoxic drugs. e effective rate is 20.00%-30.00% [2].…”

“…The standard treatment is 4–6 cycles of platinum combined with the third generation of cytotoxic drugs. The effective rate is 20.00%–30.00% [ 2 ]. The median survival time is 8–10 months, and the time of disease progression is 3–5 months.…”