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Anti-Angiogenic Agents Combined with Immunotherapy for Advanced Non-Small Cell Lung Cancer: A Systematic Review and
Heng Lin1, Chenhui Ma2, Aihong Zhong1
1Department of Oncology, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, Fujian, 350008, China.
Background:
Anti-angiogenic agents could enhance tumor immunity response, and anti- angiogenesis plus immunotherapy has become a novel treatment option for advanced non-small cell lung cancer (NSCLC). The efficacy of this combination therapy remains controversial and obscure.
Aim:
We conducted a meta-analysis to evaluate the clinical efficacy and safety of this therapeutic strategy in patients with advanced NSCLC and provide more guidance for treating NSCLC clinically.
Methods:
A systematic literature search was performed in PubMed, Embase, Web of Science, CNKI, and Wanfang databases to identify relevant studies published up to December 2021. The primary endpoint was the objective response rate (ORR). Second endpoints were progression-free survival (PFS), overall survival (OS), and grade ≥3 AEs adverse events (AEs). The sensitivity analysis was conducted to confirm the stability of the results. STATA 15.0 was utilized for all pooled analyses.
Results:
Eleven studies were eventually included in the meta-analysis, involving 533 patients with advanced NSCLC. The pooled ORR rate was 27% (95% CI 18% to 35%; I2 =84.2%; p<0.001), while the pooled median PFS and OS was 5.84 months (95% CI 4.66 to 7.03 months; I2=78.4%; p<0.001) and 14.20 months (95% CI 11.08 to 17.32 months; I2=82.2%; p=0.001), respectively. Most common grade ≥3 AEs included hypertension, hand-foot syndrome, diarrhea, adrenal insufficiency, hyponatremia, proteinuria, rash, thrombocytopenia, and fatigue.
Conclusion:
Anti-angiogenesis combined with immunotherapy demonstrated satisfactory antitumor activity and an acceptable toxicity profile in patients with advanced NSCLC. The pooled results of our meta-analysis provided further evidence supporting the favorable efficacy and safety of this therapeutic strategy.
Insights
Combination therapy of anti-angiogenesis and immunotherapy shows promising antitumor activity for advanced non-small cell lung cancer (NSCLC). This meta-analysis confirms favorable efficacy and safety, offering guidance for NSCLC treatment.
Area of Science:
- Oncology
- Immunotherapy
- Cancer Research
Background:
- Advanced non-small cell lung cancer (NSCLC) treatment benefits from enhanced tumor immunity via anti-angiogenic agents.
- The combination of anti-angiogenesis and immunotherapy is a novel strategy for advanced NSCLC, but its efficacy is debated.
Approach:
- A meta-analysis systematically reviewed 11 studies up to December 2021, including 533 patients with advanced NSCLC.
- Primary endpoint: objective response rate (ORR). Secondary endpoints: progression-free survival (PFS), overall survival (OS), and severe adverse events (AEs).
- Statistical analysis was performed using STATA 15.0, with sensitivity analysis to ensure result stability.
Key Points:
- The pooled objective response rate (ORR) was 27% (95% CI 18% to 35%).
- Pooled median progression-free survival (PFS) was 5.84 months (95% CI 4.66 to 7.03 months) and overall survival (OS) was 14.20 months (95% CI 11.08 to 17.32 months).
- Common grade ≥3 adverse events included hypertension, hand-foot syndrome, and diarrhea.
Conclusions:
- Anti-angiogenesis combined with immunotherapy demonstrates significant antitumor activity in advanced NSCLC patients.
- The treatment strategy shows an acceptable toxicity profile, supporting its use in clinical practice.
- This meta-analysis provides robust evidence for the efficacy and safety of this combination therapy in advanced NSCLC.
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