Chemoradiotherapy alone or in combination with Endostar for patients with advanced non-small cell lung cancer: A systematic review and meta-analysis

Previous studies show inconsistent effect estimates for the efficacy of Endostar in patients with advanced non-small cell lung cancer (NSCLC) undergoing chemoradiotherapy. Therefore, this meta-analysis aimed to determine the effectiveness and safety on the basis of data obtained from available randomized controlled trials (RTCs). We find relevant articles reporting the use of Endostar combined with chemoradiotherapy regimens in the treatment of advanced NSCLC. The retrieval period was from June 2008 to June 2018. A total of 11 RTCs that recruited a total of 735 patients were included. Overall, the results indicated that patients who received Endostar plus chemoradiotherapy showed a significantly increased incidence of objective response rate (ORR) (relative risk [RR] = 1.48; 95% confidence interval [CI] = 1.31-1.67; P < 0.00001) and disease control rate (DCR) (RR = 1.17; 95% CI = 1.09-1.25; P < 0.00001) compared with those who received chemoradiotherapy alone. However, no significant difference was noted between groups for 1-year survival rate (RR = 1.06; 95% CI = 0.91-1.23; P = 0.48). Furthermore, combined Endostar with chemoradiotherapy did not yield a high incidence of stable and elevated Karnofsky performance score (RR = 1.06; 95% CI = 0.91-1.23; P = 0.48). Moreover, no significant difference was noted in the incidence of total toxicity between the two groups. The findings of our study indicated that treatment with Endostar plus chemoradiotherapy yielded a high incidence of ORR or DCR, but did not trigger excess adverse events in patients with NSCLC.