Abstract
Purpose The purpose of this study was to evaluate the efficacy and safety of a nanodrug delivery regimen compared with conventional drug administration for the treatment of lung cancer. Materials and Methods Studies were retrieved through PubMed, Web of Science, and ScienceDirect. Primary and secondary outcome measures, including overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events, were extracted from the retrieved literature and systematically evaluated. Results Six trials, including 4806 advanced non-small-cell lung cancer patients, were included in this study. Compared with conventional drug administration in the treatment of lung cancer, the nanodrug delivery regimen improved the ORR (risk ratio = 1.43, 95% confidence interval (CI) = 1.25–1.63, p ≤ 0.001), prolonged PFS (hazard ratio (HR) = 0.83, 95% CI = 0.76–0.92, p ≤ 0.001), and obtained superior OS (HR = 0.91, 95% CI = 0.83–0.99, p ≤ 0.001). Regarding safety, the incidence of neutropenia, alopecia, sensory neuropathy, myalgia, and arthralgia was lower in the nanoadministration group, but the risk of thrombocytopenia, anaemia, and nausea was increased. Conclusion Nanodrug administration is safe and effective in patients with non-small-cell lung cancer to some extent.
Highlights
IntroductionLung cancer is the second most frequently diagnosed cancer and the leading cause of cancer deaths worldwide in 2020, accounting for approximately one in nine cancers (11.4%) and one in six deaths (18.0%), with an estimated 2.2 million new cancer cases and 1.8 million deaths [1]
Lung cancer is the second most frequently diagnosed cancer and the leading cause of cancer deaths worldwide in 2020, accounting for approximately one in nine cancers (11.4%) and one in six deaths (18.0%), with an estimated 2.2 million new cancer cases and 1.8 million deaths [1].According to histological classification, lung cancer can be divided into epithelial tumors, mesenchymal tumors, lymphohistiocytic tumors, tumors of ectopic origin, and metastatic tumors [2]
Materials and Methods is systematic review and network meta-analysis was registered under the PROSPERO platform (#CRD42021268340). We completed this meta-analysis following the guidelines for systematic reviews and metaanalysis, the PRSIMA 2009 checklist, and the preferred reporting items in the Cochrane Handbook. e questions studied in this study follow the principles of population, intervention, comparison, results, and study design. e population included patients with non-small-cell carcinoma and lung cancer. e intervention used is nanoadministration, and the control is conventional administration. e outcome measures included overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). e type of experimental design included in this study is a randomized controlled trial (RCT)
Summary
Lung cancer is the second most frequently diagnosed cancer and the leading cause of cancer deaths worldwide in 2020, accounting for approximately one in nine cancers (11.4%) and one in six deaths (18.0%), with an estimated 2.2 million new cancer cases and 1.8 million deaths [1]. A comprehensive study from the TYROL registry has shown that the majority of patients with NSCLC are already at an advanced stage at the time of initial diagnosis and have multiple comorbidities [6], which limits treatment options. In patients with advanced NSCLC who use PD-1/programmed cell death 1 ligand 1 (PD-L1) inhibitors, PD-L1 expression is a predictive biomarker for ORR [10]. All of these treatments have some limitations. A study conducted by Mahsa Shahriari et al showed that nanodrug delivery could improve the clinical outcome of NSCLC patients [22] These studies included a small sample size and some included only older adults; the accuracy and conclusions of the studies may not be comprehensive enough, requiring confirmation. We completed this meta-analysis following the guidelines for systematic reviews and metaanalysis, the PRSIMA 2009 checklist, and the preferred reporting items in the Cochrane Handbook. e questions studied in this study follow the principles of population, intervention, comparison, results, and study design. e population included patients with non-small-cell carcinoma and lung cancer. e intervention used is nanoadministration, and the control is conventional administration. e outcome measures included overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). e type of experimental design included in this study is a randomized controlled trial (RCT)
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