Abstract
BackgroundTumor necrosis factor (TNF) has been investigated to be correlated with the occurrence and progression of lung cancer. This investigation was to assess the efficacy and safety of recombinant mutant human tumor necrosis factor (rmhTNF) for controlling malignant pleural effusion (MPE) through thoracic perfusion.MethodsThrough searching from MEDLINE, Web of Science, EMBASE, Cochrance Library, OVID and China National Knowledge Infrastructure (CNKI), a total of 12 studies with 694 patients were included in this study. A series of meta-analysis methods were used to analyze the extracted data.ResultsThoracic perfusion of rmhTNF combined with cisplatin promoted the objective response rate (ORR) (P < 0.001; odds ratio = 4.49) and the quality of life (QOL) of patients with MPE (P < 0.001; odds ratio = 10.33), as compared with cisplatin alone. Although the participation of rmhTNF increased the incidence of fever (P < 0.001), it seemed to relieve the adverse reactions in the digestive tract (P = 0.017).ConclusionsThoracic perfusion of rmhTNF contributes to the treatment of MPE and improves the QOL of MPE patients.
Highlights
Tumor necrosis factor (TNF) has been investigated to be correlated with the occurrence and progression of lung cancer
Inclusion criteria for selecting studies Inclusion criteria: (1) patients must be diagnosed with lung cancer and malignant tumor cells must be identified from the pleural cavity by cytology and histology; (2) study must compare the efficacy and safety between recombinant mutant human tumor necrosis factor (rmhTNF) plus cisplatin and cisplatin alone by thoracic perfusion for treating malignant pleural effusion (MPE); (3) the supportive treatment and the clinical baseline of two groups must be basically equal; and (4) the outcome measures, including objective response rate (ORR), disease control rate (DCR), symptom improvement (SI) and adverse effects (AEs) must be reported
The results showed that the odds ratio was 10.33, suggesting that the presence of rmhTNF improved the quality of life (QOL) of patients with MPE (Fig. 2c)
Summary
Tumor necrosis factor (TNF) has been investigated to be correlated with the occurrence and progression of lung cancer. This investigation was to assess the efficacy and safety of recombinant mutant human tumor necrosis factor (rmhTNF) for controlling malignant pleural effusion (MPE) through thoracic perfusion. In China, a new recombinant mutant human tumor necrosis factor (rmhTNF) has been developed, which is a product obtained by modifying the TNF gene using the polymerase chain reaction technology based on the tumor necrosis factor cDNA template prototype, resulting in a non-glycosylated single chain consisting of 151 amino acids with a molecular weight of 16,598 Da [13]. This research is a systematic evaluation and meta-analysis to quantify the efficacy and safety of rmhTNF in the treatment of MPE caused by lung cancer
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