Background and objective: Vandetanib is a small molecule inhibitor against vascular endothelial growth factor receptor (VEGFR) and epidermal growth factor receptor (EGFR). The aim of this study is to evaluate the efficacy and safety of vandetanib as a second-line treatment for advanced non-small cell lung cancer (NSCLC).
Methods: We selected randomized controlled trials (RCTs) on vandetanib for NSCLC from PubMed, Medline, Embase, VIP and CNKI. Meta-analysis was completed using software Review Manager 5.0.
Results: Compared with the control group (single other targeted therapy or chemotherapy group), there were statistical differences in progression free survival (PFS) (OR=1.23, 95%CI: 1.05-1.45), partial response (PR) (OR=2.15, 95%CI: 1.59-2.93), disease control (DC) (OR=1.22, 95%CI: 1.06-1.40), diarrhea (OR=1.59, 95%CI: 1.38-1.83), nausea (OR=0.69, 95%CI: 0.57-0.83), rash (OR=2.07, 95%CI: 1.71- 2.49), constipation (OR=0.81, 95%CI: 0.67-0.97), and vomiting (OR=0.72, 95%CI: 0.60-0.87) in the vandetanib group, but there were no differences in overall survival (OS), stable disease (SD), fatigue, cough, anorexia and dyspnea.
Conclusions: Vandetanib might have more superior efficacy as a second-line treatment for NSCLC, but its advantages in terms of safety were not demonstrated.
背景与目的: 凡德他尼是抑制血管内皮生长因子受体（vascular endothelial growth factor receptor, VEGFR）和内皮生长因子受体（endothelial growth factor receptor, EGFR）的小分子药物，本研究旨在系统评价凡德他尼作为二线方案治疗非小细胞肺癌（non-small cell lung cancer, NSCLC）的有效性和安全性。
方法: 检索PubMed、Medline、Embase、维普、中国期刊全文数据库等数据库，收集凡德他尼治疗NSCLC的随机对照试验，用Revman 5.0软件对数据进行meta分析。
结果: 与对照组（单用一种其它靶向药物或化疗药物）相比，凡德他尼组在疾病无进展生存期（OR=1.23, 95%CI: 1.05-1.45）、部分缓解（OR=2.15, 95%CI: 1.59-2.93）、疾病控制（OR=1.22, 95%CI: 1.06-1.40）、腹泻（OR=1.59, 95%CI: 1.38-1.83）、恶心（OR=0.69, 95%CI: 0.57-0.83）、皮疹（OR=2.07, 95%CI: 1.71-2.49）、便秘（OR=0.81, 95%CI: 0.67-0.97）、呕吐（OR=0.72, 95%CI: 0.60-0.87）等方面有统计学差异，但总生存期、疾病稳定、疲乏、咳嗽、食欲减退、呼吸困难等方面无统计学差异。
结论: 凡德他尼作为二线方案治疗晚期NSCLC的疗效有一定的优势，但是其安全性无明显优势。