TY - JOUR
T1 - Maintenance or consolidation therapy in small-cell lung cancer
T2 - A systematic review and meta-analysis
AU - Rossi, Antonio
AU - Garassino, Marina Chiara
AU - Cinquini, Michela
AU - Sburlati, Paola
AU - Di Maio, Massimo
AU - Farina, Gabriella
AU - Gridelli, Cesare
AU - Torri, Valter
PY - 2010/11
Y1 - 2010/11
N2 - Objective: To assess the role of maintenance or consolidation therapy in the treatment of small-cell lung cancer (SCLC), a meta-analysis of all published randomized clinical trials (RCTs) was performed in order to provide an overall meta-analysis and indirectly compare the effect of chemotherapy, interferons, and other biologic agents. Methods: Electronic databases were searched for publication reporting of RCTs comparing maintenance or consolidation therapy versus placebo or follow-up alone until December 2008. Hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS), with their relative 95% confidence intervals (CI), were derived. In the calculation of HRs, the " no maintenance" arm served as a reference. The a priori value of p2 test for heterogeneity: 8.07 [3 df]; p=0.04), but not for PFS. A statistically significant reduction of mortality was detected in those studies assessing the efficacy of chemotherapy (HR 0.89, 95% CI 0.81-0.98; p=0.02) and of interferon-alpha (HR 0.78, 95% CI 0.64-0.96; p=0.02). Conclusions: The maintenance or the consolidation approach failed to improve the outcomes of SCLC. A survival advantage is suggested for maintenance chemotherapy and interferon-alpha, but its clinical impact needs to be confirmed by further studies.
AB - Objective: To assess the role of maintenance or consolidation therapy in the treatment of small-cell lung cancer (SCLC), a meta-analysis of all published randomized clinical trials (RCTs) was performed in order to provide an overall meta-analysis and indirectly compare the effect of chemotherapy, interferons, and other biologic agents. Methods: Electronic databases were searched for publication reporting of RCTs comparing maintenance or consolidation therapy versus placebo or follow-up alone until December 2008. Hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS), with their relative 95% confidence intervals (CI), were derived. In the calculation of HRs, the " no maintenance" arm served as a reference. The a priori value of p2 test for heterogeneity: 8.07 [3 df]; p=0.04), but not for PFS. A statistically significant reduction of mortality was detected in those studies assessing the efficacy of chemotherapy (HR 0.89, 95% CI 0.81-0.98; p=0.02) and of interferon-alpha (HR 0.78, 95% CI 0.64-0.96; p=0.02). Conclusions: The maintenance or the consolidation approach failed to improve the outcomes of SCLC. A survival advantage is suggested for maintenance chemotherapy and interferon-alpha, but its clinical impact needs to be confirmed by further studies.
KW - Chemotherapy
KW - Consolidation therapy
KW - Immunotherapy
KW - Maintenance therapy
KW - Meta-analysis
KW - SCLC
KW - Targeted therapy
UR - http://www.scopus.com/inward/record.url?scp=77957020019&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77957020019&partnerID=8YFLogxK
U2 - 10.1016/j.lungcan.2010.02.001
DO - 10.1016/j.lungcan.2010.02.001
M3 - Article
C2 - 20188431
AN - SCOPUS:77957020019
VL - 70
SP - 119
EP - 128
JO - Lung Cancer
JF - Lung Cancer
SN - 0169-5002
IS - 2
ER -