title: Efficacy and safety profile of combining vandetanib with chemotherapy in patients with advanced non-small cell lung cancer: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety profile of combining vandetanib with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).
  
  
  METHODS
  MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ASCO Abstracts, ESMO Abstracts, Wanfang Database, CNKI were searched. Eligible studies were the randomized clinical trials (RCTs) that compared the efficacy and safety profile of adding vandetanib to chemotherapy with single chemotherapy in patients with advanced NSCLC. The outcomes included overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and toxicities. All meta-analysis were performed using Review Manager 5.1. The fixed-effect model weighted by the Mantel-Haenszel method was used. When considerable heterogeneity was found (p<0.1, or I(2)>50%), further analysis (subgroup analysis, sensitivity analysis or random-effect model) was performed to identify potential cause.
  
  
  RESULTS
  Results reported from 5 RCTs involving 2284 patients were included in the analysis. Compared to chemotherapy alone, the addition of vandetanib resulted in a significant longer PFS (HR 0.79 [0.72-0.87], p<0.00001) and a higher ORR (RR 1.75 [1.43-2.15], p<0.00001), but failed to show advantage on OS (HR 0.96 [0.87-1.06], p = 0.44).
  
  
  CONCLUSIONS
  Vandetanib has activity in NSCLC. Identification of predictive biomarkers is warranted in future trials to select a subset of patients with advanced NSCLC who may benefit from vandetanib.
authors.affiliation: Department of oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Tian
authors.forename: Wenping
authors.initials: W
authors.lastname: Ding
authors.forename: Sungkyoung
authors.initials: S
authors.lastname: Kim
authors.forename: Leizhen
authors.initials: L
authors.lastname: Zheng
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Li
authors.forename: Jianchun
authors.initials: J
authors.lastname: Gu
authors.forename: Lian
authors.initials: L
authors.lastname: Zhang
authors.forename: Minggui
authors.initials: M
authors.lastname: Pan
authors.forename: Siyu
authors.initials: S
authors.lastname: Chen
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D016206:Databases, Bibliographic; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; C452423:vandetanib