Pooled Analysis of the Clinical Benefit of Cyclooxygenase-2 Inhibitors Combined with Chemotherapy in Advanced Non-small Cell Lung Cancer

Overview

Journal Transl Cancer Res

Specialty Oncology

Date 2022 Feb 4

PMID 35116868

Authors

Wei Zheng

Zhi-Min Liao

Yan Fu

Ya-Peng Wu

Qiong Zhang

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to perform a systematic review of the interventions for advanced non-small cell lung cancer (NSCLC) including chemotherapy alone and chemotherapy plus COX-2 inhibitors to identify and discuss the cause of any variation across studies and to explore the best currently available evidence.

Methods: The literature was comprehensively searched to identify relevant meta-analyses, and the Jadad decision algorithm was used to select the best evidence from the included meta-analyses. Quality assessment of the meta-analyses was performed using the Quality of Reporting (QUOROM) checklist and the Oxman-Guyatt quality index.

Results: Five meta-analyses were selected for inclusion in this study. Three were published prior to 2018 and had Oxman-Guyatt scores of 5. Only one study had the highest QUOROM and Oxman-Guyatt scores, and that study concluded that first-line treatment with chemotherapy plus COX-2 inhibitors was superior to chemotherapy alone in terms of the overall response rate (ORR). However, no significant difference in clinical benefit, progression-free survival (PFS), overall survival (OS), or 1-year survival rate was found. In addition, toxicities of the drugs had some influence on patients with heart disease.

Conclusions: The Jadad algorithm identified the optimal current meta-analysis. COX-2 inhibitors increased the ORR when combined with chemotherapy, but did not improve the survival indices. In addition, they may increase the risk of cardiovascular events and hematological toxicities in NSCLC patients.

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References

Gridelli C, Gallo C, Ceribelli A, Gebbia V, Gamucci T, Ciardiello F . Factorial phase III randomised trial of rofecoxib and prolonged constant infusion of gemcitabine in advanced non-small-cell lung cancer: the GEmcitabine-COxib in NSCLC (GECO) study. Lancet Oncol. 2007; 8(6):500-12. DOI: 10.1016/S1470-2045(07)70146-8. View

Hou L, Huang F, Xu H . Does celecoxib improve the efficacy of chemotherapy for advanced non-small cell lung cancer?. Br J Clin Pharmacol. 2015; 81(1):23-32. PMC: 4693572. DOI: 10.1111/bcp.12757. View

Khuri F, Wu H, Lee J, Kemp B, Lotan R, Lippman S . Cyclooxygenase-2 overexpression is a marker of poor prognosis in stage I non-small cell lung cancer. Clin Cancer Res. 2001; 7(4):861-7. View

Van Dyke A, Cote M, Prysak G, Claeys G, Wenzlaff A, Murphy V . COX-2/EGFR expression and survival among women with adenocarcinoma of the lung. Carcinogenesis. 2008; 29(9):1781-7. PMC: 2527644. DOI: 10.1093/carcin/bgn107. View

Hold G, El-Omar E . Genetic aspects of inflammation and cancer. Biochem J. 2008; 410(2):225-35. DOI: 10.1042/BJ20071341. View

Oxman A, Guyatt G . Validation of an index of the quality of review articles. J Clin Epidemiol. 1991; 44(11):1271-8. DOI: 10.1016/0895-4356(91)90160-b. View

Nugent F, Mertens W, Graziano S, Levitan N, Collea R, Gajra A . Docetaxel and cyclooxygenase-2 inhibition with celecoxib for advanced non-small cell lung cancer progressing after platinum-based chemotherapy: a multicenter phase II trial. Lung Cancer. 2005; 48(2):267-73. DOI: 10.1016/j.lungcan.2004.11.004. View

Altorki N, Keresztes R, Port J, Libby D, Korst R, Flieder D . Celecoxib, a selective cyclo-oxygenase-2 inhibitor, enhances the response to preoperative paclitaxel and carboplatin in early-stage non-small-cell lung cancer. J Clin Oncol. 2003; 21(14):2645-50. DOI: 10.1200/JCO.2003.07.127. View

Masferrer J, LEAHY K, Koki A, Zweifel B, Settle S, Woerner B . Antiangiogenic and antitumor activities of cyclooxygenase-2 inhibitors. Cancer Res. 2000; 60(5):1306-11. View

10.

Moher D, Cook D, Eastwood S, Olkin I, Rennie D, Stroup D . Improving the Quality of Reports of Meta-Analyses of Randomised Controlled Trials: The QUOROM Statement. Onkologie. 2001; 23(6):597-602. DOI: 10.1159/000055014. View

11.

Edelman M, Wang X, Hodgson L, Cheney R, Baggstrom M, Thomas S . Phase III Randomized, Placebo-Controlled, Double-Blind Trial of Celecoxib in Addition to Standard Chemotherapy for Advanced Non-Small-Cell Lung Cancer With Cyclooxygenase-2 Overexpression: CALGB 30801 (Alliance). J Clin Oncol. 2017; 35(19):2184-2192. PMC: 5493050. DOI: 10.1200/JCO.2016.71.3743. View

12.

Sher T, Dy G, Adjei A . Small cell lung cancer. Mayo Clin Proc. 2008; 83(3):355-67. DOI: 10.4065/83.3.355. View

13.

Sahin M, Sahin E, Gumuslu S . Cyclooxygenase-2 in cancer and angiogenesis. Angiology. 2008; 60(2):242-53. DOI: 10.1177/0003319708318378. View

14.

Chen J, Shen P, Zhang X, Zhao M, Zhang X, Yang L . Efficacy and safety profile of celecoxib for treating advanced cancers: a meta-analysis of 11 randomized clinical trials. Clin Ther. 2014; 36(8):1253-63. DOI: 10.1016/j.clinthera.2014.06.015. View

15.

Kokawa A, Kondo H, Gotoda T, Ono H, Saito D, NAKADAIRA S . Increased expression of cyclooxygenase-2 in human pancreatic neoplasms and potential for chemoprevention by cyclooxygenase inhibitors. Cancer. 2001; 91(2):333-8. DOI: 10.1002/1097-0142(20010115)91:2<333::aid-cncr1006>3.0.co;2-n. View

16.

Pildal J, Hrobjartsson A, Jorgensen K, Hilden J, Altman D, Gotzsche P . Impact of allocation concealment on conclusions drawn from meta-analyses of randomized trials. Int J Epidemiol. 2007; 36(4):847-57. DOI: 10.1093/ije/dym087. View

17.

Edelman M, Watson D, Wang X, Morrison C, Kratzke R, Jewell S . Eicosanoid modulation in advanced lung cancer: cyclooxygenase-2 expression is a positive predictive factor for celecoxib + chemotherapy--Cancer and Leukemia Group B Trial 30203. J Clin Oncol. 2008; 26(6):848-55. DOI: 10.1200/JCO.2007.13.8081. View

18.

Edelman M, Tan M, Fidler M, Sanborn R, Otterson G, Sequist L . Randomized, double-blind, placebo-controlled, multicenter phase II study of the efficacy and safety of apricoxib in combination with either docetaxel or pemetrexed in patients with biomarker-selected non-small-cell lung cancer. J Clin Oncol. 2014; 33(2):189-94. PMC: 4890680. DOI: 10.1200/JCO.2014.55.5789. View

19.

Jadad A, Cook D, Browman G . A guide to interpreting discordant systematic reviews. CMAJ. 1997; 156(10):1411-6. PMC: 1227410. View

20.

Lasalvia-Prisco E, Goldschmidt P, Galmarini F, Cucchi S, Vazquez J, Aghazarian M . Addition of an induction regimen of antiangiogenesis and antitumor immunity to standard chemotherapy improves survival in advanced malignancies. Med Oncol. 2012; 29(5):3626-33. PMC: 3505507. DOI: 10.1007/s12032-012-0301-1. View