Endostar combined with chemotherapy versus chemotherapy alone for advanced NSCLCs: a meta-analysis

To evaluate the clinical efficacy and safety of rh-endostatin (Endostar) combined with chemotherapy in the treatment of patients with non-small cell lung cancer (NSCLC), we selected data from the Cochrane Library, EMBASE, Medline, SCI, CBM, CNKI, etc to obtain all clinical controlled trials, including the addition of endostar to chemotherapy in advanced NSCLC patients. The quality of included trials was evaluated by two reviewers independently. The software RevMan 5.0 was provided by Cochrane Collaboration and used for meta-analyses. Fifteen trials with 1335 patients were included according to the including criterion. All trials were randomized controlled trials, and two trials were adequate in reporting randomization. Thirteen trials didn't mention the blinding methods. Meta-analysis indicated that the NPE arm (Vinorelbine+ cisplatin+Endostar) had a different response rate compared with NP(Vinorelbine+ cisplatin) arm (OR2.16, 95%CI 1.57 to 2.99). The incidences of severe Leukopenia (OR0.94, 95%CI 0.66 to 1.32) and severe thrombocytopenia (OR 1.00, 95%CI 0.64 to 1.57) and Nausea and vomiting (OR 0.85, 95%CI 0.61 to 1.20) were similar in the NPE arm compared with those in the NP arm. The NPE plus radiotherapy(RT) arm had a similar response rate compared with NP plus RT arm (OR 2.39, 95%CI 0.99 to 5.79). The incidences of Leukopenia (OR0.83, 95%CI 0.35 to 1.94) and thrombocytopenia (OR 0.78, 95%CI 0.19 to 3.16) and radiation esophagitis (OR 1.00, 95%CI 0.40 to 2.49)were similar in the NPE plus RT arm compared with those in the NP plus RT arm. Our results suggest that in the treatment of advanced NSCLCs, Endostar in combination with platinum-based chemotherapy can improve the response rate without obviously increasing side effects.