The efficacy and toxicity of metronomic oral vinorelbine monotherapy in patients with non-small cell lung cancer: a meta
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ORIGINAL ARTICLE
The efficacy and toxicity of metronomic oral vinorelbine monotherapy in patients with non‑small cell lung cancer: a meta‑analysis Ke Xu1 · Tao Liu1 · Jie Zhang1 · Yangang Zhou1 · Fang Yang1 · Tao Ren1 Received: 28 October 2019 / Accepted: 11 May 2020 © Japan Society of Clinical Oncology 2020
Abstract Purpose To evaluate the efficacy and toxicity of metronomic oral vinorelbine monotherapy in patients with stage IIIB/IV and advanced non-small cell lung cancer (NSCLC). Methods The PubMed, Embase, Cochrane library, Wanfang, and CNKI databases were searched for relevant studies. The overall response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and incidence of severe adverse events (grade ≥ 3 adverse events; grade 3/4 AEs) were calculated using the methods of merging ratios and means. Merged ratios and means and their 95% confidence intervals (CIs) were used to descriptively analyze the efficacy and toxicity of metronomic oral vinorelbine monotherapy in patients with stage IIIB/IV and advanced NSCLC. Results The ORR and DCR achieved with metronomic oral vinorelbine monotherapy were 12% (95% CI 5–20) and 48% (95% CI 38–59), respectively. Median PFS and OS were 3.46 months (95% CI 2.49–4.43) and 8.22 months (95% CI 7.21–9.24), respectively. The incidence of grade 3/4 AEs was 16% (95% CI 10–22). The more common grade 3/4 AEs were neutropenia 9% (95% CI 2–20) and leukopenia 8% (95% CI 1–19). Conclusion Metronomic oral vinorelbine monotherapy has a certain effect on patients with stage IIIB/IV and advanced NSCLC, especially for untreated elderly patients. It offers the advantages of convenience, lower cost and acceptable incidence of severe adverse events. Keywords Vinorelbine · Metronomic chemotherapy · NSCLC · Meta-analysis
Background Lung cancer is the most common cause of cancer-associated morbidity and mortality worldwide [1]. Non-small cell lung cancer (NSCLC) accounts for about 85% of the incidence of lung cancer [2]; an estimated 70% of these patients have advanced stage disease at the time of diagnosis [3, 4]. Currently, chemotherapy plays an important role in the treatment of patients with locally advanced and metastatic NSCLC who are unsuitable or unable to receive targeted therapy and immunotherapy. As one of the traditional chemotherapy drugs for metastatic NSCLC, vinorelbine in combination
* Ke Xu [email protected] 1
Department of Oncology, The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Street, Xindu District, Chengdu 610500, Sichuan, People’s Republic of China
with gemcitabine is still recommended for patients who are unsuitable for targeted therapy or immunotherapy [5]. Metronomic chemotherapy (MCT) refers to high-frequency, continuous administration of low-dose chemotherapy (usually 1/10th–1/3rd dose of conventional chemotherapy) [6]. The mechanisms of action of such schedule include inhibition of tumor cell proliferation, antitumor angiogenesis, antidrug resistance, immunomodulation, modulation of clo
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