Comparison of Endostar continuous versus intermittent intravenous infusion in combination with first‐line chemotherapy in patients with advanced non‐small cell lung cancer

Cheng, Yuan; Nie, Lei; Liu, Ying; Jin, Zhe Wu; Wang, Xi; Hu, Zhanwei

doi:10.1111/1759-7714.13106

Cited by 11 publications

(23 citation statements)

References 13 publications

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“…advanced NSCLC treated with CIV Endostar combined with chemotherapy showed a significantly higher disease control rate (86.2% vs. 70.7%, P < 0.01), longer median PFS (six months vs. four months, P = 0.037) and median OS (17.5 months vs. 13.5 months, P = 0.034) compared with IV Endostar combined with chemotherapy. The trend seen in the single‐center retrospective study by Cheng et al .19 was similar to that in the report by Li et al . Yao et al .…”

Section: Discussionsupporting

confidence: 88%

Different administration routes of recombinant human endostatin combined with concurrent chemoradiotherapy might lead to different efficacy and safety profile in unresectable stage III non‐small cell lung cancer: Updated follow‐up results from two phase II trials

Hui

Peng

et al. 2020

Thoracic Cancer

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Background There are two main choices of administration route of recombinant human endostatin (Endostar) available and the treatment options of concurrent chemoradiotherapy (CCRT) have changed over time. The aim of this study was to observe the long‐term efficacy and safety of different administration routes of Endostar combined with CCRT. Methods Patients with unresectable stage III non‐small cell lung cancer (NSCLC) from two phase II trials were included as two cohorts. Both were treated with Endostar combined with CCRT. Endostar was administrated by intravenous injection (7.5 mg/m2/day, seven days) in the IV arm and by continuous intravenous pumping (7.5 mg/m2/24 hours, 120 hours) in the CIV arm. Results A total of 48 patients were included in the IV arm and 67 patients in the CIV arm. The median progression‐free survival (PFS), overall survival (OS), local recurrence‐free survival (LRFS) and distant metastasis‐free survival (DMFS) in the IV arm and CIV arm were 9.9 months versus 15.4 months (HR = 0.751, 95% CI 0.487–1.160, P = 0.200), 24.0 months versus 38.5 months (HR = 0.746, 95% CI 0.473–1.178, P = 0.209), 32.3 months versus 27.1 months (HR = 1.193, 95% CI 0.673–2.115, P = 0.546), 20.1 months versus 49.7 months (HR = 0.603, 95% CI 0.351–1.036, P = 0.067). The one, three, five‐year PFS in the IV arm and CIV arm was 45.8% versus 52.9%, 18.3% versus 31.4%, and 18.3% versus 27.7% and the one, three, five‐year OS was 81.2% versus 82.1%, 31.1% versus 50.3%, and 31.1% versus 41%, respectively. Incidence of hematological adverse reactions were numerically lower in the CIV arm than the IV arm. Conclusions Endostar delivered by CIV with CCRT may be a better option than IV in terms of potential survival and safety for unresectable stage III NSCLC. Key points Significant findings of the study Endostar delivered by continuous intravenous pumping might achieve more favorable survival over intravenous injection and reduce adverse hematological reactions in patients with unresectable stage III NSCLC treated with Endostar combined with CCRT.What this study adds The administration route of recombinant human endostatin is also one key factor for survival and safety to consider when treating patients with unresectable stage III NSCLC.

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Section: Discussionsupporting

confidence: 88%

Different administration routes of recombinant human endostatin combined with concurrent chemoradiotherapy might lead to different efficacy and safety profile in unresectable stage III non‐small cell lung cancer: Updated follow‐up results from two phase II trials

Hui

Peng

et al. 2020

Thoracic Cancer

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“…Three thousand eight hundred thirty-one records were further excluded as they did not meet the inclusion criteria. Finally, nine studies were identified as eligible for inclusion in this systematic review, including four cohort studies [18][19][20][21] and two RCTs [22,23] and three NRCTs [24][25][26]. Table 1 showed the characteristics of included studies.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 597 advanced NSCLC participants were included (CIV: 300 and IIV: 297), with ages ranging from 24 to 78 years. The histological types of NSCLC included both SqCC and ADC in five studies [20][21][22][23][24], only SqCC in one study [18], and were unknown in three studies [19,25,26]. TNM staging of advanced NSCLC included both stage III and IV in six studies [18][19][20][22][23][24], only stage IV in one study [26], and were not reported in two studies [21,25].…”

Section: Discussionmentioning

confidence: 99%

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Endostar continuous versus intermittent intravenous infusion combined with chemotherapy for advanced NSCLC: a systematic review and meta-analysis including non-randomized studies

Wang¹,

Li³

et al. 2020

BMC Cancer

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Background Both intermittent intravenous (IIV) infusion and continuous intravenous (CIV) infusion of Endostar are widely used for NSCLC in China. We aimed to compare the efficacy and safety of CIV of Endostar versus IIV in combination with first-line chemotherapy for patients with advanced NSCLC. Methods RCTs, NRCTs and cohort studies which compared CIV of Endostar with IIV in advanced NSCLC patients and reported efficacy or safety outcomes were eligible. Two reviewers independently screened records, extracted data and assessed risk of bias. Pooled risk ratios (RRs) with 95% confidence intervals were calculated using random effects meta-analysis for short-term efficacy and safety outcomes, and hazard ratios (HRs) for survival outcomes. Results Finally nine studies involving 597 patients were included, containing two RCTs, three NRCTs and four cohort studies. For short-term efficacy, moderate quality of evidence showed that there were no significant differences between CIV of Endostar and IIV in objective response rate (ORR; RR 1.34, 95% CI 0.91–1.98, P = 0.14) and disease control rate (DCR; RR 1.11, 95% CI 0.94–1.30, P = 0.21). Very low quality of evidence indicated that CIV of Endostar significantly improved both overall survival (OS; HR 0.69, 95% CI 0.48–0.99, P = 0.046) and progression-free survival (PFS; HR 0.71, 95% CI 0.55–0.93, P = 0.01) compared with IIV. As for safety outcomes, moderate quality of evidence found that CIV of Endostar significantly reduced the risk of myelosuppression (RR 0.55, 95% CI 0.32–0.96, P = 0.03) and cardiovascular toxicity (RR 0.21, 95% CI 0.06–0.78, P = 0.02) compared with IIV. Conclusions In advanced NSCLC, compared with IIV, CIV of Endostar had similar short-term efficacy, and substantially lower risk of myelosuppression and cardiovascular toxicity. Although very low quality of evidence supported the survival benefit of CIV compared with IIV, large RCTs with long-term follow-up are needed to demonstrate survival benefits. Caution should be given for off-label use of CIV of Endostar.

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“…These studies provide an important experimental basis for combining endostatin with radiotherapy within the time window of 7 days (range, 5–10) after endostatin administration. In addition, given the short half-life of endostatin in vivo, CIV is considered a better delivery route to maintain a steady concentration and may improve its efficacy [ 49 – 51 ]. A recent study [ 52 ] which compared the outcomes of two phase II trials that involved different administration routes of endostatin combined with CCRT showed that endostatin at 7.5 mg/m 2 /24 h CIV for 5 days achieved higher 3- and 5-year OS rates (50.3, 41%) and safety than endostatin at 7.5 mg/m 2 /day IV for 7 days.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of recombinant human endostatin combined with radiotherapy or chemoradiotherapy in patients with locally advanced non-small cell lung cancer: a pooled analysis

et al. 2020

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Purpose: To assess the efficacy and safety of recombinant human endostatin in combination with radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC). Methods: We searched eligible literature in available databases using combinations of the following search terms: lung cancer, endostatin or endostar, radiotherapy or radiation therapy or chemoradiotherapy. The inclusion criteria were: prospective or retrospective (including single-arm) studies that evaluated the efficacy and safety of endostatin plus radiotherapy (ERT) or concurrent chemoradiotherapy (ECRT) in patients with LA-NSCLC. Primary outcomes included the following: objective response rate (ORR), local control rates (LCR), overall survival (OS), progression-free survival (PFS), and adverse events (AEs). Tests of heterogeneity, sensitivity, and publication bias were performed. Results: A total of 271 patients with LA-NSCLC from 7 studies were enrolled, including six prospective trials and one retrospective study. The pooled median PFS was 11.3 months overall, 11.2 months in the ECRT group, and 11.8 months in the ERT group. Pooled median OS and ORR were 18.9 months and 77.2% overall, 18.4 months and 77.5% in the ECRT group, and 19.6 months and 76.1% in the ERT group, respectively. The incidences of major grade ≥ 3 AEs for all patients, subgroups of ECRT and ERT were 10.9% vs 11.9% vs 9.4% for radiation pneumonitis, 11.6% vs 12.2% vs 9.4% for radiation esophagitis, 35.5% vs 43.4% vs 0 for leukopenia, 27.8% vs 40.7% vs 2.1% for neutropenia, and 10.5% vs 12.3% vs 2.1% for anemia. Conclusions: Combined endostatin with RT or CCRT is effective and well tolerated in treating LA-NSCLC, and less toxicities occur. Further validation through prospective randomized control trials is required.

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Comparison of Endostar continuous versus intermittent intravenous infusion in combination with first‐line chemotherapy in patients with advanced non‐small cell lung cancer

Cited by 11 publications

References 13 publications

Different administration routes of recombinant human endostatin combined with concurrent chemoradiotherapy might lead to different efficacy and safety profile in unresectable stage III non‐small cell lung cancer: Updated follow‐up results from two phase II trials

Different administration routes of recombinant human endostatin combined with concurrent chemoradiotherapy might lead to different efficacy and safety profile in unresectable stage III non‐small cell lung cancer: Updated follow‐up results from two phase II trials

Endostar continuous versus intermittent intravenous infusion combined with chemotherapy for advanced NSCLC: a systematic review and meta-analysis including non-randomized studies

Efficacy and safety of recombinant human endostatin combined with radiotherapy or chemoradiotherapy in patients with locally advanced non-small cell lung cancer: a pooled analysis

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