Anti-Angiogenic Agents Combined with Immunotherapy for Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis


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Abstract

Background:Anti-angiogenic agents could enhance tumor immunity response, and anti- angiogenesis plus immunotherapy has become a novel treatment option for advanced non-small cell lung cancer (NSCLC). The efficacy of this combination therapy remains controversial and obscure.

Aim:We conducted a meta-analysis to evaluate the clinical efficacy and safety of this therapeutic strategy in patients with advanced NSCLC and provide more guidance for treating NSCLC clinically.

Methods:A systematic literature search was performed in PubMed, Embase, Web of Science, CNKI, and Wanfang databases to identify relevant studies published up to December 2021. The primary endpoint was the objective response rate (ORR). Second endpoints were progression-free survival (PFS), overall survival (OS), and grade ≥3 AEs adverse events (AEs). The sensitivity analysis was conducted to confirm the stability of the results. STATA 15.0 was utilized for all pooled analyses.

Results:Eleven studies were eventually included in the meta-analysis, involving 533 patients with advanced NSCLC. The pooled ORR rate was 27% (95% CI 18% to 35%; I2 =84.2%; p(<0.001), while the pooled median PFS and OS was 5.84 months (95% CI 4.66 to 7.03 months; I2=78.4%; p(<0.001) and 14.20 months (95% CI 11.08 to 17.32 months; I2=82.2%; p=0.001), respectively. Most common grade ≥3 AEs included hypertension, hand-foot syndrome, diarrhea, adrenal insufficiency, hyponatremia, proteinuria, rash, thrombocytopenia, and fatigue.

Conclusion:Anti-angiogenesis combined with immunotherapy demonstrated satisfactory antitumor activity and an acceptable toxicity profile in patients with advanced NSCLC. The pooled results of our meta-analysis provided further evidence supporting the favorable efficacy and safety of this therapeutic strategy.

About the authors

Heng Lin

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian

Email: info@benthamscience.net

Chenhui Ma

Department of Thoracis Surgery, Fuzhou Pulmonary Hospital of Fujian

Email: info@benthamscience.net

Aihong Zhong

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian

Email: info@benthamscience.net

Huanping Zang

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian

Email: info@benthamscience.net

Wenxin Chen

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian

Email: info@benthamscience.net

Lixiu Li

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian

Email: info@benthamscience.net

Yuyin Le

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian

Email: info@benthamscience.net

Qiang Xie

Department of Oncology, Fuzhou Pulmonary Hospital of Fujian

Author for correspondence.
Email: info@benthamscience.net

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