Efficacy Of Maintenance Therapies In Small Cell Lung Cancer:a Meta Analysis

Lung cancer is the leading cause of cancer-related mortality. Small cell lungcancer (SCLC) accounted for almost15%of all lung cancer. SCLC is considered tobe an aggressive form of lung cancer that is characterized by a rapid doubling time,early onset of dissemination, high sensitivity to chemotherapy/radiotherapy and highresponse rates. Although overall response rates are high for all stages, most patientsrelapse after discontinuing treatment, most become resistant disease. The outcome ispoor. Maintenance therapy of small cell lung cancer is being researching, especiallyspecific targeted therapy drugs for various signal transduction pathway inmaintenance therapy after first-line chemotherapy.Objective:To assess the efficacy and toxicity of maintenance therapy in treatment of smallcell lung cancer (SCLC).Materials and Methods:Electronic databases were searched for publication reporting of RCTs comparingmaintenance targeted therapies versus placebo or follow-up alone from2000to2015.Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS),their relative95%confidence intervals (CI), as well as other toxicity index were derived. We used RevMan5.3to perform meta-analysis.Results:Eleven RCTs, encompassing2258patients, were eligible for the present analysis.Overall, no statistical advantage in OS [HR=0.99,95%CI(0.91,1.09), P=0.89]、PFS[HR=0.89,95%CI(0.79,1.01), P=0.07] was reported for maintenance therapy. Also,no statistical advantage in1-year survival rate [HR=0.94,95%CI(0.80,1.12), P=0.50],2-year survival rate [HR=1.02,95%CI(0.81,1.28), P=0.90] or1-year progression-freesurvival rate [HR=0.97,95%CI(0.79,1.20), P=0.78]. About toxicity, there was onlystatistical differences of vomiting [OR=0.39,95%CI(0.18,0.84), P=0.02] andsensory neuropathy [OR=2.73,95%CI(1.50,4.97), P=0.001].Conclusion:1. The maintenance therapies failed to improve the outcomes of SCLC；2. Maintenance therapies significantly increase the occurrence of Ⅲ/Ⅳvomiting and sensory neuropathy.3. Sunitinib is the most promising drug in maintenance therapy.