A Systematic Review:Comparison Of Platinum-based Doublet Versus Non-Platinum Single-agent As Second-line Treatment Of Advanced Non-Small-Cell Lung Cancer

Objective:In patients with advanced non-small cell lung cancer (NSCLC), the benefit-to-risk ratio of Platinum-based doublet versus non-Platinum single-agent is not established. The aim of study is to systematically evaluate on the efficacy and safety of both two kinds of chemotherapy. Methods:Randomized controlled trials (RCTs) on Platinum-based doublet vs. non-Platinum single-agent for patients with advanced NSCLC were searched in PubMed, The Cochrane Library, web of science, CBM, CNKI and Wanfang data. Meta-analysis were performed with RevMan5.2 software. Results:The final analysis included 11 RCTs, covering 1,167 patients. The meta-analyses showed that compared with the non-Platinum single-agent chemotherapy, Platinum-based doublet increased the objective response rate (ORR) (RR=1.43,95%CI:1.08～1.89, P=0.010)and disease control rate (DCR) (RR=1.16,95%CI:1.05～1.27, P=0.002), respectively. Platinum-based doublet also significantly increased progression-free survival (PFS) (HR=0.74,95%CI:0.58～0.95, P=0.020), but there were no significant difference between the two groups in 1-year overall survival rate (RR=1.21,95%CI:0.91～1.61, P=0.190).The main adverse reactions were thrombocytopenia(RR=2.99,95%CI: 1.95～4.59, P<0.001). Grade3/4 leukopenia, neutropenia and nausea/vomiting, Anemia, the difference between the two groups had no statistical significance. Conclusion: Compared with non-Platinum single-agent, Platinum-based doublet can improve ORR, DCR and PFS in advance NSCLC patients, but not significantly improved 1-year survival rate. And the main adverse events were thrombocytopenia, low toxicity and well tolerated. Therefore, Platinum-based doublet are worthy of further promotion in patients with advanced NSCLC failed first-line treatment.