1262P - Multi-targeted antiangiogenic tyrosine kinase inhibitors in advanced non-small cell lung cancer: An updated meta-analysis of 20 randomized controll...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer agents
Non-Small Cell Lung Cancer
Therapy
Biological Therapy
Presenter Wenhua Liang
Citation Annals of Oncology (2014) 25 (suppl_4): iv426-iv470. 10.1093/annonc/mdu349
Authors W. Liang, X. Wu, L. Zhang
  • Department Of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, 510060 - Guangzhou/CN

Abstract

Aim

Multi-targeted antiangiogenic tyrosine kinase inhibitors (MATKIs) have been studied by many randomized controlled trials (RCTs) in treatments of advanced non-small cell lung cancer (NSCLC). Here we performed a timely meta-analysis to summarize the most up-to-date evidences and examined the effect of covariates on outcomes through subgroup analyses.

Methods

Electronic databases were searched for eligible studies. We defined the experimental arm as MATKI-containing group while the control arm as MATKI-free group. The extracted data on objective response rates (ORR) and progression-free survival (PFS) were pooled. Subgroup analyses that stratified trials according to chemotherapy history, eligible histological type and treatment modality were conducted.

Results

A total of 20 phase II/III RCTs that involved a total of 10834 participants were included. In overall, MATKI-containing group was associated with significant superior ORR (OR 1.29, 95% CI 1.08 to 1.55, P = 0.006) and prolonged PFS (HR 0.84, 0.78 to 0.90, P < 0.001) compared to MATKI-free group. Subgroup analyses indicated that trials enrolling patients previously treated with chemotherapy or trials considering squamous NSCLC as well, or trials using MATKIs in combination with the control regimens as experimental arms, showed greater magnitude of benefits.

Outcome Subgroup No. of Arms OR/HR Effect size P
ORR Overall 22 1.29 2.77 0.01
Chemo-history Chemo-Naïve 12 1.12 0.85 0.40
Previous-Chemo 10 1.55 3.27 0.001
Histology All Histology 17 1.38 2.59 0.01
Non-Squamous 5 1.14 0.89 0.37
Modality Combination 17 1.45 4.61 <0.001
Single agent 5 0.77 0.88 0.38
PFS Overall 21 0.84 5.02 <0.001
Chemo-history Chemo-Naïve 10 0.85 3.68 <0.001
Previous-Chemo 11 0.82 3.72 <0.001
Histology All Histology 15 0.81 4.80 <0.001
Non-Squamous 6 0.90 1.50 0.13
Modality Combination 17 0.80 7.50 <0.001
Single agent 5 1.00 0.02 0.99

Conclusions

This up-to-date meta-analysis showed that MATKIs could increase ORR and prolong PFS. The advantages of MATKIs were most highlighted in combination with standard treatments and in the second/third-line settings. Additionally, the inclusion criteria regarding histology in future studies on MATKIs warrants further discussed.

Disclosure

All authors have declared no conflicts of interest.