Efficacy and Safety of Apatinib Alone or Apatinib Plus Paclitaxel/docetaxel Versus Paclitaxel/docetaxel in the Treatment of Advanced Non-small Cell Lung Cancer: A Meta-analysis

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2021 Oct 8

PMID 34622571

Citations 9

Authors

Zhe Li

Zhibao Liu

Yuanyuan Wu

Huarui Li

Zhen Sun

Chenggang Han

Xiaoling Zhang

Jinghua Zhang

Affiliations

Soon will be listed here.

Abstract

Background: To investigate the efficacy and safety of apatinib alone or apatinib plus paclitaxel/docetaxel versus paclitaxel/docetaxel in the treatment of advanced non-small cell lung cancer (NSCLC) through pooling of open published data.

Methods: The electronic databases of Medline (1960-2021.5), Cochrane central register of controlled trials (CENTRAL), EMBASE(1980-2021.5) and Wan fang (1986-2021.5) were systematically searched by two reviewers to identify the relevant clinical trials related to the above subject. The objective response rate (ORR), disease control rate (DCR) and drug relevant adverse reactions were pooled and demonstrated by risk ratio (RR) and 95% confidence interval (95% CI). The statistical heterogeneity across studies was assessed by I-square test. The publication bias was evaluated by Egger's line regression test and demonstrated by Begg's funnel plot.

Results: Eleven prospective studies were included in the meta-analysis. The pooled results indicated that the ORR (RR = 1.62, 95% CI: 1.32-2.00, p < 0.05) and DCR (RR = 1.29, 95% CI: 1.18-1.41, p < 0.05) of apatinib alone or apatinib plus paclitaxel/docetaxel was significantly higher than that of the paclitaxel/docetaxel group for advanced NSCLC, respectively. The drug-related adverse reaction was not statistically different between apatinib alone or apatinib plus paclitaxel/docetaxel with regard to the hand-foot syndrome, gastrointestinal reaction, thrombocytopenia, anemia and leukocytopenia (p > 0.05) except for hypertension (RR = 3.60, 95% CI: 1.26-10.31, p < 0.05). Subgroup analysis also indicated that the hypertension and hand-foot syndrome in apatinib + paclitaxel/docetaxel were higher than that of the paclitaxel/docetaxel group with a statistical difference (p < 0.05).

Conclusions: Apatinib alone or apatinib plus paclitaxel/docetaxel was superior to paclitaxel/docetaxel for ORR and DCR. However, combined treatment with apatinib appears to increase the risk of a patient developing an adverse reaction, especially hypertension and hand-foot syndrome.

Citing Articles

Efficacy and safety of apatinib plus chemotherapy vs. chemotherapy alone for the treatment of advanced‑stage non‑small cell lung cancer: A meta‑analysis.

Qin S, Han X, Li Z Oncol Lett. 2023; 27(1):25.

PMID: 38073772 PMC: 10698847. DOI: 10.3892/ol.2023.14158.

Lipid metabolism-related gene signatures for predicting the prognosis of lung adenocarcinoma.

Cao X, Wu B, Hou Y, Chen J Transl Cancer Res. 2023; 12(8):2099-2114.

PMID: 37701116 PMC: 10493788. DOI: 10.21037/tcr-23-375.

Efficacy and safety of apatinib combined with radiotherapy in the treatment of advanced pancreatic cancer: a meta-analysis.

Ma Y, Li J, Wen L, Zhang G, Yao X World J Surg Oncol. 2023; 21(1):165.

PMID: 37264386 PMC: 10236655. DOI: 10.1186/s12957-023-03055-0.

The apatinib and pemetrexed combination has antitumor and antiangiogenic effects against NSCLC.

Zhou L, Zhang W, Xiang Y, Qian Z, Zhou J, Ni L Open Life Sci. 2023; 18(1):20220533.

PMID: 36910471 PMC: 9993329. DOI: 10.1515/biol-2022-0533.

Exploring immune checkpoint inhibition in combination with anti-angiogenic therapy for patients with EGFR- or ALK-positive advanced non-small cell lung cancer.

De Giglio A, Di Federico A, Metro G Transl Lung Cancer Res. 2022; 11(9):1734-1738.

PMID: 36248330 PMC: 9554691. DOI: 10.21037/tlcr-22-492.

References

Zhang H . Apatinib for molecular targeted therapy in tumor. Drug Des Devel Ther. 2015; 9:6075-81. PMC: 4654530. DOI: 10.2147/DDDT.S97235. View

Yu G, Yang J, Ye B, Xu L, Li X, Zheng G . Apatinib in the treatment of advanced non-small-cell lung cancer: A meta-analysis. Math Biosci Eng. 2019; 16(6):7659-7670. DOI: 10.3934/mbe.2019383. View

Hu R, Li T, Hui K, Chen Z, Wang N, Wu X . Apatinib sensitizes chemoresistant NSCLC cells to doxetaxel via regulating autophagy and enhances the therapeutic efficacy in advanced and refractory/recurrent NSCLC. Mol Med Rep. 2020; 22(5):3935-3943. PMC: 7533512. DOI: 10.3892/mmr.2020.11492. View

Hu Y, Zhou N, Wang R . Apatinib strengthens the anti-tumor effect of cisplatin in thyroid carcinoma through downregulating VEGFR2. J BUON. 2021; 26(2):613-619. View

Montanino A, Manzo A, Carillio G, Palumbo G, Esposito G, Sforza V . Angiogenesis Inhibitors in Small Cell Lung Cancer. Front Oncol. 2021; 11:655316. PMC: 8195287. DOI: 10.3389/fonc.2021.655316. View

Zhou K, Zhang J, Wang Q, Liu W, Liu J, Yao L . Apatinib, a selective VEGFR2 inhibitor, improves the delivery of chemotherapeutic agents to tumors by normalizing tumor vessels in LoVo colon cancer xenograft mice. Acta Pharmacol Sin. 2018; 40(4):556-562. PMC: 6461765. DOI: 10.1038/s41401-018-0058-y. View

Lin C, Lin Y, Huang T, Shi C, Yang C, Yang Y . VEGF mediates fat embolism-induced acute lung injury via VEGF receptor 2 and the MAPK cascade. Sci Rep. 2019; 9(1):11713. PMC: 6690961. DOI: 10.1038/s41598-019-47276-4. View

Wen S, Shao G, Zheng J, Zeng H, Luo J, Gu D . Apatinib regulates the cell proliferation and apoptosis of liver cancer by regulation of VEGFR2/STAT3 signaling. Pathol Res Pract. 2019; 215(4):816-821. DOI: 10.1016/j.prp.2019.01.021. View

Sheng L, Gao J, Xu Q, Zhang X, Huang M, Dai X . Selection of optimal first-line immuno-related therapy based on specific pathological characteristics for patients with advanced driver-gene wild-type non-small cell lung cancer: a systematic review and network meta-analysis. Ther Adv Med Oncol. 2021; 13:17588359211018537. PMC: 8165528. DOI: 10.1177/17588359211018537. View

10.

Macedo-Perez E, Morales-Oyarvide V, Mendoza-Garcia V, Dorantes-Gallareta Y, Flores-Estrada D, Arrieta O . Long progression-free survival with first-line paclitaxel plus platinum is associated with improved response and progression-free survival with second-line docetaxel in advanced non-small-cell lung cancer. Cancer Chemother Pharmacol. 2014; 74(4):681-90. DOI: 10.1007/s00280-014-2522-9. View

11.

Yu Z, Cai X, Xu Z, He Z, Lai J, Wang W . Apatinib plus Chemotherapy as a Second-Line Treatment in Unresectable Non-Small Cell Lung Carcinoma: A Randomized, Controlled, Multicenter Clinical Trial. Oncologist. 2020; 25(11):e1640-e1649. PMC: 7648327. DOI: 10.1634/theoncologist.2020-0519. View

12.

Shukla N, Yan M, Hanna N . The Story of Angiogenesis Inhibitors in Non-small-cell Lung Cancer: The Past, Present, and Future. Clin Lung Cancer. 2020; 21(4):308-313. DOI: 10.1016/j.cllc.2020.02.024. View

13.

Li N, Wang Z, Yuan G, Sun Y, Zhang R, Li X . An Oral Small Molecule VEGFR2 Inhibitor, Apatinib, in Patients with Recurrent or Refractory Cervical Cancer: A Real World Study. J Oncol. 2020; 2020:3852373. PMC: 7327550. DOI: 10.1155/2020/3852373. View

14.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

15.

Siegel R, Miller K, Jemal A . Cancer statistics, 2020. CA Cancer J Clin. 2020; 70(1):7-30. DOI: 10.3322/caac.21590. View

16.

Geng R, Li J . Apatinib for the treatment of gastric cancer. Expert Opin Pharmacother. 2014; 16(1):117-22. DOI: 10.1517/14656566.2015.981526. View

17.

Scott A, Messersmith W, Jimeno A . Apatinib: a promising oral antiangiogenic agent in the treatment of multiple solid tumors. Drugs Today (Barc). 2015; 51(4):223-9. DOI: 10.1358/dot.2015.51.4.2320599. View

18.

Cantelmo A, Dejos C, Kocher F, Hilbe W, Wolf D, Pircher A . Angiogenesis inhibition in non-small cell lung cancer: a critical appraisal, basic concepts and updates from American Society for Clinical Oncology 2019. Curr Opin Oncol. 2019; 32(1):44-53. DOI: 10.1097/CCO.0000000000000591. View

19.

Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109):629-34. PMC: 2127453. DOI: 10.1136/bmj.315.7109.629. View

20.

Li Z, Liu Z, Wu Y, Li H, Sun Z, Han C . Efficacy and safety of apatinib alone or apatinib plus paclitaxel/docetaxel versus paclitaxel/docetaxel in the treatment of advanced non-small cell lung cancer: A meta-analysis. Thorac Cancer. 2021; 12(21):2838-2848. PMC: 8563161. DOI: 10.1111/1759-7714.14131. View