Clinical Edge

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Adding This to Chemo for NSCLC Betters Response, But…

Lung Cancer; 2016 Dec; Li, Barnes, Chan et al

Adding anti-angiogenic tyrosine kinase inhibitors (AATKI) to chemotherapy in people with advanced non-small-cell lung cancers (NSCLC) substantially improved progression-free survival and overall response rate, according to a meta-analysis of 15 trials involving nearly 8,000 individuals. However, it did not improve overall survival, and there was increased toxicity and treatment-related deaths.

Investigators looked at trials that evaluated AATKIs plus chemotherapy vs chemotherapy alone. Among the results:

  • Patients who had AATKIs added saw their progression-free survival odds improve by 17%.
  • Overall response rate improved by 63%.
  • Although overall survival was not different when analyzing all patients, those with adenocarcinoma saw their overall survival odds improve by 14%; those in the second line setting experienced a 15% improvement.
  • Patients who had AATKI added were more than twice as likely to experience grade ≥3 toxicity.
  • They were also more than twice as likely to experience treatment-related death.

Citation:

Li B, Barnes T, Chan D, et al. The addition of anti-angiogenic tyrosine kinase inhibitors to chemotherapy for patients with advanced non-small-cell lung cancers: A meta-analysis of randomized trials. Lung Cancer.2016;102:21-27. doi:doi.org/10.1016/S1470-2045(16)30500-9.