Abstract
ObjectiveTo assess the efficacy and toxicity of anlotinib for the treatment of refractory advanced non-small-cell lung cancer (NSCLC).MethodsWe systematically searched databases for randomized controlled trials on anlotinib treatment for patients with advanced NSCLC published until November 6, 2020. Articles were assessed and data were extracted independently by two investigators. Further, we analyzed hazard ratios (HRs) for progression-free and overall survival (PFS and OS, respectively). In addition, we analyzed risk ratio (RR) for overall response and disease control rates (ORR and DCR, respectively) and the odds ratio (OR) for the main adverse events (AEs) using RevMan 5.3 software.ResultsThis analysis included 594 patients from three clinical studies. The pooled HRs for PFS and OS were 0.27 (95% confidence interval (CI): 0.22–0.33, P < 0.001) and 0.68 (95% CI: 0.56–0.83, P < 0.001), respectively, indicating that anlotinib administration significantly improved PFS and OS in patients with advanced NSCLC. The pooled RRs for ORR and DCR were 11.62 (95% CI: 2.75–49.14, P < 0.001) and 2.30 (95% CI: 1.91–2.77, P < 0.001), respectively, indicating that anlotinib administration in patients with advanced NSCLC improved ORR and DCR. The pooled OR for AEs of grade 3 or higher was 2.94 (95% CI: 1.99–4.35, P < 0.001), indicating that AEs of grade 3 or higher were more prevalent in the anlotinib group than in the placebo group.ConclusionAnlotinib, an effective choice of third- or later line therapy for patients with refractory advanced NSCLC, provides clinical benefits in terms of PFS, OS, ORR, and DCR. AEs associated with anlotinib were tolerable.
Highlights
Lung cancer is the most common cancer and the leading cause of cancer-related death worldwide [1]
The pooled hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS) were 0.27 (95% confidence interval (CI): 0.22–0.33, P < 0.001) and 0.68, respectively, indicating that anlotinib administration significantly improved PFS and OS in patients with advanced Non-small-cell-lung cancer (NSCLC)
The pooled risk ratio (RR) for objective response rate (ORR) and disease control rate (DCR) were 11.62 and 2.30, respectively, indicating that anlotinib administration in patients with advanced NSCLC improved ORR and DCR
Summary
Lung cancer is the most common cancer and the leading cause of cancer-related death worldwide [1]. Surgery can be successful for a minority of these patients, but the 5-year survival has been reported to be under 23% for patients with advanced NSCLC who receive surgical treatment [3]. Platinum-based dual-drug chemotherapy is the traditional standard approach for the treatment of advanced NSCLC; the corresponding 5-year survival rate remains very low at
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