Maintenance or consolidation therapy in small-cell lung cancer: A systematic review and meta-analysis

Antonio Rossi, Marina Chiara Garassino, Michela Cinquini, Paola Sburlati, Massimo Di Maio, Gabriella Farina, Cesare Gridelli, Valter Torri

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)119-128
Number of pages10
JournalLung Cancer
Issue number2
Publication statusPublished - Nov 2010


  • Chemotherapy
  • Consolidation therapy
  • Immunotherapy
  • Maintenance therapy
  • Meta-analysis
  • SCLC
  • Targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research


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