Efficacy and safety of recombinant human Ad-p53 injection combined with cisplatin in treating malignant pleural effusion: a Meta-analysis

Abstract

Objective To assess the efficacy and safety of recombinant human Ad-p53 (rAd-p53) injection combined with cisplatin in treating malignant pleural effusion by conducting a Meta-analysis. Methods A comprehensive collection of randomized controlled studies (RCTs) of rAd-p53 combined with cisplatin versus single cisplatin in the treatment of malignant pleural effusion was retrieved form Cochrane Library, Pubmed, EMBase, CBM, CNKI, Wanfang and VIP databases. Meta-analysis was conducted by RevMan 5.2 software. Results Ten RCTs involving 538 patients were identified in the study. The Meta-analysis results showed that rAd-p53 combined with cisplatin group had a higher hydrothorax total remission rate than single cisplatin group (RR=1.67, 95%CI: 0.90-2.01; Z=5.51, P=0.000 01). The PS score in rAd-p53 combined with cisplatin group was better than that in single cisplatin group (RR=1.76, 95%CI: 1.45-2.14; Z=5.69, P<0.000 01). The incidence rate of adverse reaction of heating in the former was higher than that in the latter (RR=3.10, 95%CI: 2.25-4.27; Z=6.94, P<0.000 01). There were no significant differences in adverse reactions of chest pain (RR=0.99, 95%CI: 0.50-1.96; Z=0.04, P=0.97), gastrointestinal reaction (RR=1.16, 95%CI: 0.90-1.50; Z=1.13, P=0.26) and marrow suppression (RR=1.09, 95%CI: 0.81-1.47; Z=0.59, P=0.55) between the two groups. Conclusion rAd-p53 combined with cisplatin therapy for the treatment of malignant pleural effusion is superior to single cisplatin therapy. Mean while, fever is self-limited, and the safety is identified. It is worthy for promotion of rAd-p53 injection combined with cisplatin in clinical treatment of advanced malignant pleural effusion. Key words: Pleural effusion, malignant; Cisplatin; Meta-analysis; Recombinant human Ad-p53