title: Angiogenesis inhibitors for the treatment of small cell lung cancer (SCLC): A meta-analysis of 7 randomized controlled trials.
abstract: BACKGROUND
  This study aimed to assess the effectiveness and safety of angiogenesis inhibitors for the treatment of patients with small cell lung cancer (SCLC) via meta-analysis.
  
  
  METHODS
  Electronic databases including PubMed, Embase, and Cochrane Library were searched to look for eligible studies through February 1, 2016. RCTs comprising angiogenesis inhibitors and nonangiogenesis inhibitors for SCLC patients were investigated. The extracted data including overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were summarized. In addition, the common adverse events (AEs) were also explored.
  
  
  RESULTS
  There were 7 phase II/III RCTs, encompassing 1322 SCLC patients eligible for meta-analysis. In comparison to nonangiogenesis inhibitors, angiogenesis inhibitors treatment was not associated with improvement of PFS [HR = 0.87, 95% CI (0.74-1.02), P = 0.09), OS [HR = 0.99, 95% CI (0.88-1.12), P = 0.91], or ORR [OR = 1.12, 95% CI (0.85-1.47), P = 0.41). Also, there was no improvement in 1-year survival rate [OR = 0.96, 95% CI (0.74-1.19), P = 0.63)], 2-year survival rate [OR = 1.00, 95% CI (0.66-1.51), P = 1.00)] or 1-year progression-free survival rates [OR = 0.95, 95% CI (0.69-1.31), P = 0.76)]. However, from subgroup analyses, it was observed that angiogenesis inhibitors improved ORR [HR = 1.66 (95% CI 1.02-2.71), P = 0.04] in phase II studies and bevacizumab improved PFS [HR = 0.73 (95% CI 0.42-0.97), P = 0.04]. It is important to note that angiogenesis inhibitors reduced emesis [OR = 0.38, 95% CI (0.17-0.85), P = 0.02], but increased incidence of constipation [OR = 4.02, 95% CI (2.14-7.55), P < 0.0001) and embolism [OR = 2.24, 95% CI (1.45-3.47), P = 0.0003).
  
  
  CONCLUSIONS
  Adding angiogenesis inhibitors to chemotherapy did not improve PFS, OS, ORR, 1-year survival rate, 2-year survival rate or 1-year progression-free survival rate for SCLC. However, subgroup analysis revealed that bevacizumab enhanced PFS. Angiogenesis inhibitors also had a high incidence of constipation and embolism.
authors.affiliation: Department of Medical Oncology, The First Affiliated Hospital of Xi'an JiaoTong University Department of Respiratory Medicine, Xi'an Central Hospital, Xi'an, Shaanxi, P.R. China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.forename: Tao
authors.initials: T
authors.lastname: Wu
authors.forename: Li
authors.initials: L
authors.lastname: Jing
authors.forename: Miao-Jing
authors.initials: MJ
authors.lastname: Li
authors.forename: Tao
authors.initials: T
authors.lastname: Tian
authors.forename: Zhi-Ping
authors.initials: ZP
authors.lastname: Ruan
authors.forename: Xuan
authors.initials: X
authors.lastname: Liang
authors.forename: Ke-Jun
authors.initials: KJ
authors.lastname: Nan
authors.forename: Zhi-Yan
authors.initials: ZY
authors.lastname: Liu
authors.forename: Yu
authors.initials: Y
authors.lastname: Yao
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors