Abstract
PurposeTo assess the efficacy and safety of recombinant human endostatin in combination with radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC).MethodsWe searched eligible literature in available databases using combinations of the following search terms: lung cancer, endostatin or endostar, radiotherapy or radiation therapy or chemoradiotherapy. The inclusion criteria were: prospective or retrospective (including single-arm) studies that evaluated the efficacy and safety of endostatin plus radiotherapy (ERT) or concurrent chemoradiotherapy (ECRT) in patients with LA-NSCLC. Primary outcomes included the following: objective response rate (ORR), local control rates (LCR), overall survival (OS), progression-free survival (PFS), and adverse events (AEs). Tests of heterogeneity, sensitivity, and publication bias were performed.ResultsA total of 271 patients with LA-NSCLC from 7 studies were enrolled, including six prospective trials and one retrospective study. The pooled median PFS was 11.3 months overall, 11.2 months in the ECRT group, and 11.8 months in the ERT group. Pooled median OS and ORR were 18.9 months and 77.2% overall, 18.4 months and 77.5% in the ECRT group, and 19.6 months and 76.1% in the ERT group, respectively. The incidences of major grade ≥ 3 AEs for all patients, subgroups of ECRT and ERT were 10.9% vs 11.9% vs 9.4% for radiation pneumonitis, 11.6% vs 12.2% vs 9.4% for radiation esophagitis, 35.5% vs 43.4% vs 0 for leukopenia, 27.8% vs 40.7% vs 2.1% for neutropenia, and 10.5% vs 12.3% vs 2.1% for anemia.ConclusionsCombined endostatin with RT or CCRT is effective and well tolerated in treating LA-NSCLC, and less toxicities occur. Further validation through prospective randomized control trials is required.
Highlights
Lung cancer is the most common cancer type worldwide [1], and non-small cell lung cancer (NSCLC) is the most common form (80–85%) [2]
Study selection and search strategy Studies that met the following inclusion criteria were included in the pooled analysis: 1) prospective or retrospective studies that evaluated the efficacy and safety of endostatin plus radiotherapy (ERT) or concurrent chemoradiotherapy (ECRT) in patients with LA-NSCLC; 2) studies with primary outcomes reporting at least one of the following endpoints: objective response rate (ORR), progression-free survival (PFS) and overall survival (OS), and local control rates (LCR), or adverse events (AEs) based on Common Terminology Criteria for Adverse Events version 3.0 or 4.0; 3) number of cases included for study was ≥10; 4) articles or abstracts were written in English
212 evaluable patients in four studies received endostatin combined with concurrent chemoradiotherapy (CCRT) (ECRT) and 59 evaluable patients in three studies received endostatin combined with single RT (ERT)
Summary
Lung cancer is the most common cancer type worldwide [1], and non-small cell lung cancer (NSCLC) is the most common form (80–85%) [2]. No significant progress in the treatment of LA-NSCLC was made for many years until the PACIFIC study confirmed that consolidation therapy with durvalumab (a monoclonal antibody that blocks interactions of programmed cell death ligand 1 with the PD-1 receptor) further improved survival following CRT [6,7,8]. Prior to the findings of the PACIFIC study, researchers explored whether patients with LA-NSCLC could benefit from anti-angiogenic drugs combined with RT or CRT. Earlier studies showed that administration of bevacizumab along with thoracic RT led to a high incidence of pulmonary toxicity, including radiation pneumonitis, hemoptysis and tracheoesophageal fistulae, in patients with stage III NSCLC [12, 13].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
