Intraperitoneal Perfusion Therapy of Endostar Combined with Platinum Chemotherapy for Malignant Serous Effusions: A Meta-analysis.

Rong Liang,Yan Lin,Hai-Ying Xie,Yong-Qiang Li,Qian Li,Chun-Ling Yuan,Zhi-Hui Liu

doi:10.7314/apjcp.2015.16.18.8637

Rong Liang, Yan Lin + Show 5 more

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https://doi.org/10.7314/apjcp.2015.16.18.8637

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Abstract

Malignant serous effusions (MSE) are one complication in patients with advanced cancer. Endostar is a new anti-tumor drug targeting vessels which exerts potent inhibition of neovascularization. This study aimed to systematically evaluate the efficacy and safety of intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions (MSE). Randomized controlled trials (RCTs) on intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions were searched in the electronic data of PubMed, EMBASE, Web of Science, CNKI, VIP, CBM and WanFang. The quality of RCTs was evaluated by two independent researchers and a meta-analysis was performed using RevMan 5.3 software. The total of 25 RCTs included in the meta-analysis covered 1,253 patients, and all literature quality was evaluated as "B" grade. The meta-analysis showed that Endostar combined with platinum had an advantage over platinum alone in terms of response rate of effusions (76% vs 48%, RR=1.63, 95%CI: 1.50-1.78, P<0.00001) and improvement rate in quality of life (69% vs 44%, RR=1.57, 95%CI: 1.42-1.74, P<0.00001). As for safety, there was no significant difference between the two groups in the incidences of nausea and vomiting (35% vs 34%, RR=1.01, 95%CI: 0.87-1.18, P=0.88), leucopenia (38% vs 38%, RR=1, 95%CI: 0.87-1.15, P=0.99), and renal impairment (18% vs 20%, RR=0.86, 95%CI: 0.43-1.74, P=0.68). Endostar combined with platinum by intraperitoneal perfusion is effective for malignant serous effusions, and patient quality of life is significantly improved without the incidence of adverse reactions being obviously increased.

Highlights

Malignant serous effusions (MSE) are one of the common complications in patients with advanced cancer, with serious impact on systemic antitumor treatment and quality of life, suggesting a poor prognosis for patients
Endostar combined with platinum by intraperitoneal perfusion is effective for malignant serous effusions, and patient quality of life is significantly improved without the incidence of adverse reactions being obviously increased
vascular endothelial growth factor (VEGF) was significantly increased in MSE (Verheul et al, 2000; Zhou et al, 2009), in which matrix metalloproteinase (MMPs) can result in ascites formation by promoting

Summary

Introduction

Malignant serous effusions (MSE) are one of the common complications in patients with advanced cancer, with serious impact on systemic antitumor treatment and quality of life, suggesting a poor prognosis for patients. Study found that intraperitoneal perfusion of bevacizumab (A kind of anti-VEGF humanized monoclonal antibody) shows curative effect either as monotherapy or combined with other chemotherapeutic drugs (Kobold et al, 2009). This study aimed to systematically evaluate the efficacy and safety of intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions (MSE). Materials and Methods: Randomized controlled trials (RCTs) on intraperitoneal perfusion therapy of Endostar combined with platinum chemotherapy for malignant serous effusions were searched in the electronic data of PubMed, EMBASE, Web of Science, CNKI, VIP, CBM and WanFang. Conclusions: Endostar combined with platinum by intraperitoneal perfusion is effective for malignant serous effusions, and patient quality of life is significantly improved without the incidence of adverse reactions being obviously increased

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