520P - Anti-angiogenic agents in combination with chemotherapy in first-line treatment of small cell lung cancer: A systematic review and meta-analysis

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Small Cell Lung Cancer
Presenter Lei Wen
Citation Annals of Oncology (2016) 27 (suppl_9): ix169-ix169. 10.1093/annonc/mdw598
Authors L. Wen, H. Zhang
  • Oncology, Xijing Hospital, 4th Military Medical University, 710032 - Xi'an/CN



Adding angiogenesis inhibitors (such as bevacizumab) to standard chemotherapy (platinum-based) have prolonged the survival of patients in several types of cancer, including non-small cell lung cancer, colorectal cancer, etc. However, the potential role of angiogenesis inhibitors in first line treatment of small cell lung cancer (SCLC) is still controversial. Here we conducted a systematic review and meta-analysis to clarify the efficacy and safety of anti-angiogenic agents in first-line treatment of SCLC.


A systematic review and meta-analysis identified published and unpublished randomized trials comparing chemotherapy plus angiogenesis inhibitors with chemotherapy alone in first-line treatment of SCLC. Pooled hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and pooled odds ratio (OR) for adverse events were calculated. Meta-analyses were performed by using Stata 12.0.


Six eligible trials with 1328 patients (674 assigned to angiogenesis inhibitors and 654 assigned to controls) were included in the meta-analysis. Angiogenesis inhibitors included bevacizumab (3 trials), thalidomide (2 trials) and rh-endostatin (1 trial). Compared with chemotherapy alone, adding angiogenesis inhibitors significantly prolonged PFS (HR 0.80; 95% confidence interval [CI] 0.62 0.98), but not OS (HR 1.00; 95% confidence interval [CI] 0.79 1.20) for SCLC patients. In subgroup analysis, patients treated by bevacizumab (HR 0.69; 95% confidence interval [CI] 0.51 0.86) showed a significantly better PFS while thalidomide and rh-endostatin did not. Anti-angiogenic agents were associated with a higher risk of grade ≥3 thrombotic events but have no impact on hematological and other nonhematological toxic effects.


Anti-angiogenic agents, especially bevacizumab significantly prolongs PFS (but not OS) when added to first-line platinum-based chemotherapy in patients with SCLC. However, thrombotic events are also more common in anti-angiogenic agents.

Clinical trial indentification


Legal entity responsible for the study





All authors have declared no conflicts of interest.