title: Single-agent maintenance therapy in non-small cell lung cancer: a systematic review and meta-analysis.
abstract: BACKGROUND
  Can single-agent maintenance therapy be considered as an ideal strategy for non-small cell lung cancer (NSCLC) treatment to achieve prolonged survival and tolerated toxicity? A systematic review and meta-analysis was performed to elucidate this issue.
  
  
  METHODS
  The electronic databases were searched for RCTs comparing single-agent maintenance therapy with placebo, best support care or observation. The required data for estimation of response, survival and toxicity were extracted from the publications and the combined data were calculated.
  
  
  RESULTS
  Eleven RCTs involving 3686 patients were identified. We found a statistically significant higher probability of tumor response for patients with maintenance therapy versus control patients (OR: 2.80, 95%CI: 2.15 - 3.64). Patients receiving maintenance therapy had significantly longer progression-free survival (PFS) (HR: 0.67, 95%CI: 0.62 - 0.71) and overall survival (OS) (HR: 0.84, 95%CI: 0.78 - 0.90). However, maintenance therapy was associated with more severe toxicities (OR: 6.45, 95%CI: 4.61 - 9.01).
  
  
  CONCLUSIONS
  In patients with advanced NSCLC, the use of single-agent maintenance therapy is associated with higher response rate and significantly prolongs PFS and OS despite of the risk of additional toxicity.
authors.affiliation: Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, China.
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Yuan
authors.forename: Shu-Zhen
authors.initials: SZ
authors.lastname: Wei
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: Lü
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Miao
authors.forename: Ping
authors.initials: P
authors.lastname: Zhan
authors.forename: Li-Ke
authors.initials: LK
authors.lastname: Yu
authors.forename: Yi
authors.initials: Y
authors.lastname: Shi
authors.forename: Yong
authors.initials: Y
authors.lastname: Song
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D017594:Publication Bias
chemical_list: D000970:Antineoplastic Agents