Has aidi injection the attenuation and synergistic efficacy to gemcitabine and cisplatin in non-small cell lung cancer? A meta-analysis of 36 randomized controlled trials

Abstract

Gemcitabine and cisplatin is the first line chemotherapy for non-small cell lung cancer with high toxicity. Aidi injection is a cantharidin and astragalu-based Chinese herbs injection in China. Has Aidi injection attenuation and synergistic efficacy to GP in NSCLC? There is lack of strong evidence to prove it. To further reveal it, we systematically evaluated all related studies. We collected all studies about Aidi injection plus GP for NSCLC in Medline, Embase, Web of Science, CNKI, VIP, Wanfang Database, CBM, CCRCT, Chi-CTR, and US-clinical trials (established to June 2015). We evaluated their quality according to the Cochrane evaluation handbook of randomized controlled trials (5.1.0), extracted data following the PICO principles and synthesized the data by Meta analysis. Thirty six RCTs with 2582 NSCLC patients were included, with general methodological quality in most trials. The RR values and their 95% CI of Meta-analysis for ORR, DCR and QOL were as following: 1.28 (1.17, 1.39), 1.11(1.07, 1.15) and 1.81 (1.61, 2.03). The merged RD values and their 95% CI of Meta-analysis for myelosuppression, neutropenia, thrombocytopenia, neurotoxicity and nausea and vomiting were as following: -0.23(-0.29, -0.17), -0.17(-0.22, -0.11), -0.13(-0.18, -0.08), -0.06(-0.17, 0.05) and -0.15(-0.21, -0.10). To compare with GP alone, all differences were statistically significant. The available evidence indicates that Aidi injection plus GP can significantly increase the clinical efficacy and improve the QOL of patients with NSCLC. Aidi injection can reduce myelosuppression, neutropenia, thrombocytopenia neurotoxicity and nausea/vomiting. These indirectly reveal that Aidi injection has the attenuation and synergistic efficacy to GP chemotherapy in NSCLC.

Clinical Efficacy and Safety of Aidi Injection Plus Docetaxel‐Based Chemotherapy in Advanced Nonsmall Cell Lung Cancer: A Meta‐Analysis of 36 Randomized Controlled Trials

“…Compared to the previous studies [14, 31], this meta-analysis revealed that Aidi injection plus docetaxel-based chemotherapy, especially plus DP, DC, and DO, might significantly improve the ORR and DCR and 50 ml was the main dosage. Our previous meta-analysis [67, 68] had shown that Aidi injection plus radiotherapy or gemcitabine and cisplatin (GP) could significantly improve the QOL in patients with lung cancer. Can Aidi injection plus docetaxel-based chemotherapy improve the QOL?…”

“…In addition, we found that it also had low risk of anemia, hepatorenal dysfunctions, and alopecia. Our previous study [67] had shown that Aidi injection plus GP had low risk of hematological and gastrointestinal toxicity and neurotoxicity in NSCLC. Furthermore, Aidi injection could alleviate the radiotherapy related toxicity, such as myelosuppression, radiation pneumonitis, and esophagitis [68].…”

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

“…A related meta‐analysis has shown that sodium cantharidinate and vitamin B6 could improve the clinical response and QOL in patients with intermediate or advanced hepatocarcinoma. Another meta‐ananlysis has shown that cantharis and astragalus‐based Chinese Herbs injection (Aidi injection) showed synergistic efficacy to chemotherapy or radiotherapy in lung cancer. Animal studies have shown that cantharidin plus chemotherapy could significantly inhibit the growth of Lewis lung cancer.…”

“…Finally, we included 38 trials involving 2845 patients with NSCLC 62 Our previous studies 63 showed that Aidi injection plus gemcitabine and cisplatin had a low risk of haematotoxicity, neurotoxicity and nausea/vomiting in NSCLC. These studies provide indirect evidence supporting the conclusions in this meta-analysis.…”

Three Pt(ii) complexes based on thiosemicarbazone: synthesis, HSA interaction, cytotoxicity, apoptosis and cell cycle arrest

“…It functions in particular with respect to the therapy of head and neck, testicular, small lung cell and ovarian cancers. [2][3][4][5] Unfortunately, cisplatin exhibits some drawbacks including severe side effects, 6 acquired drug resistance 7 and low water-solubility, 8 which seriously limit its clinical applications. To combat those limitations, researchers have been exploring new Ptcompounds to improve antitumor efficiency.…”