Unbound MEDLINE

Addition of vandetanib to chemotherapy in advanced solid cancers: a meta-analysis.

Abstract

The addition of vandetanib to chemotherapy has been shown to have a marked effect on patients with advanced cancers who had failed previous chemotherapy. We carried out a meta-analysis to determine the efficacy and safety of vandetanib compared with chemotherapy in patients with advanced cancers. For this meta-analysis, we selected randomized clinical trials that compared vandetanib-based therapy (VBT) with the matched chemotherapy or placebo alone in patients with advanced cancers. The outcomes included overall survival (OS), progression-free survival (PFS), the objective response rate, and toxicities. Hazard ratios (HRs) and odds ratios were reported with 95% confidence intervals (CIs). A total of 14 eligible trials were included for the meta-analysis, with 2995 patients in the VBT group and 2479 patients in the control group. A significant improvement was observed in PFS (HR 0.76, 95% CI 0.68-0.86 in all cancers, HR 0.80, 95% CI 0.70-0.90 in lung cancer, HR 0.54, 95% CI 0.40-0.74 in thyroid cancer) and in objective response rate (odds ratio 2.09, 95% CI 1.42-3.07) in the VBT group. However, no significant difference was found in OS (HR 0.96, 95% CI 0.90-1.03). The subgroups of patients with non-small-cell lung cancer who benefited from vandetanib therapy were identified as those with a history of smoking (HR 0.87, 95% CI 0.80-0.95) and an adenocarcinoma histology (HR 0.85, 95% CI 0.77-0.94). In addition, patients who received VBT had an increased incidence of adverse events such as rash, diarrhea, and neutropenia. The addition of vandetanib to chemotherapy significantly improves PFS in patients with locally advanced or metastatic cancers, especially lung and thyroid cancer.

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  • Publisher Full Text

    • Authors

    Wu X, Jin Y, Cui IH, Xu Z, Zhang Y, Zhang X, Tang C, Gong Y, Chen J

    Institution

    Department of Oncology, Nanjing First Hospital, Nanjing Medical University, People's Republic of China.

    Source

    Anti-cancer drugs 23:7 2012 Aug pg 731-8

    MeSH

    Adenocarcinoma
    Antineoplastic Agents
    Antineoplastic Combined Chemotherapy Protocols
    Carcinoma, Non-Small-Cell Lung
    Disease-Free Survival
    Humans
    Lung Neoplasms
    Neoplasms
    Piperidines
    Quinazolines
    Thyroid Neoplasms
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Meta-Analysis

    Language

    eng

    PubMed ID

    22700001