Second-Line Treatments in Non-small Cell Lung Cancer
| Autor: | Paola Tombesi, Carlotta Santelmo, Emiliano Tamburini, Luigi Lazzari-Agli, Sergio Sartori, Emanuela Scarpi, Davide Tassinari |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Pulmonary and Respiratory Medicine
Oncology medicine.medical_specialty Palliative care business.industry Odds ratio Critical Care and Intensive Care Medicine Surgery law.invention Clinical trial Randomized controlled trial Docetaxel law Internal medicine medicine Number needed to treat Cardiology and Cardiovascular Medicine business Survival rate Survival analysis medicine.drug |
| Zdroj: | Chest. 135:1596-1609 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.08-1503 |
| Popis: | Background To assess the efficacy of second-line treatments in non-small cell lung cancer. Methods A systematic review of literature with metaanalysis of randomized clinical trials was independently performed by three authors. A primary analysis included all RCTs comparing any approach with placebo; a secondary analysis included all RCTs comparing any treatment with docetaxel therapy every 3 weeks. The 1-year survival rate of the primary analysis was the primary outcome of the study; the 1-year SR of the secondary analysis, response rate (RR), and time to progression of primary and secondary analyses were the secondary end points. Results Fourteen RCTs met the selection criteria. The outcomes of 2,627 and 5,952 patients were analyzed in the primary and secondary analysis, respectively. A significant heterogeneity was documented in the primary analysis for 1-year SR with odd ratio [OR] = 0.763 (p = 0.029). No heterogeneity was documented for RR in the primary analysis, with OR=0.165 (p Conclusion Second-line treatments in NSCLC seem to improve the main outcomes better than supportive care. Docetaxel administration every 3 weeks probably remains the "gold standard" because at present the data in literature are not enough to support a greater efficacy of other alternative options. Further trials are needed to identify a clinical and biological profile that could predict the response to treatments and a criterion to select the patients to be treated with chemotherapy or EGFR inhibitors. |
| Databáze: | OpenAIRE |
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