Efficacy of pemetrexed plus platinum doublet chemotherapy as first-line treatment for advanced nonsquamous non-small-cell-lung cancer: a systematic review and meta-analysis

To assess the efficacy of pemetrexed plus platinum doublet chemotherapy as first-line treatment for advanced nonsquamous non-small-cell lung cancer (NSCLC) through a trial-level meta-analysis. Trials published between 1990 and 2015 were identified by an electronic search of public databases (Medline...

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Bibliographic Details
Published in:OncoTargets and therapy 2016-01, Vol.9, p.1471-1476
Main Authors: Xiao, Huai-Qing, Tian, Rong-Hua, Zhang, Zhi-Hao, Du, Kai-Qi, Ni, Yi-Ming
Format: Article
Language:English
Subjects:
Cancer
Cancer therapies
Chemotherapy
Clinical trials
Development and progression
Drug therapy
Heart surgery
Histology
Lung cancer
Lung cancer, Non-small cell
Meta-analysis
Methods
Non-small cell lung cancer
Non-small cell lung carcinoma
Original Research
Patient outcomes
Pemetrexed
Platinum compounds
Response rates
Studies
Survival analysis
Systematic review
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Summary:To assess the efficacy of pemetrexed plus platinum doublet chemotherapy as first-line treatment for advanced nonsquamous non-small-cell lung cancer (NSCLC) through a trial-level meta-analysis. Trials published between 1990 and 2015 were identified by an electronic search of public databases (Medline, Embase, and Cochrane Library). All clinical studies were independently identified by two authors. Demographic data, treatment regimens, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were extracted and analyzed using comprehensive meta-analysis software (version 2.0). A total of 2,551 patients with advanced nonsquamous NSCLC from ten trials were included for analysis: 1,565 patients were treated with pemetrexed plus platinum doublet chemotherapy and 986 with platinum plus other first-line chemotherapy. Pooled ORR for pemetrexed plus platinum chemotherapy was 37.8% (95% confidence interval [CI]: 31.7%-44.3%), with median PFS and OS of 5.7 and 16.05 months, respectively. When compared to other platinum-based doublet chemotherapies, the use of pemetrexed plus platinum chemotherapy significantly improved OS (hazard ratio [HR] =0.86, 95% CI: 0.77-0.97, P=0.01) but not PFS (HR =0.90, 95% CI: 0.80-1.01, P=0.084) in advanced nonsquamous NSCLC patients. Pemetrexed plus platinum doublet regimen is an efficacious treatment for advanced nonsquamous NSCLC patients. Our findings support the use of pemetrexed plus platinum doublet regimen as first-line treatment in advanced nonsquamous NSCLC patients because of its potential survival benefits.
ISSN:1178-6930
1178-6930
DOI:10.2147/OTT.S96160