Lung cancer (Amsterdam, Netherlands) · 2025
Efficacy and safety of targeted therapy combined with anti-angiogenesis treatment in brain metastases of non-small cell lung cancer: a systematic review and meta-analysis.
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Pan Yin, Gu Qiaohua
Аннотация
PURPOSE: Brain metastases in non-small cell lung cancer (NSCLC) pose significant treatment challenges. This study aims to analyze whether the combination of targeted therapy and antiangiogenic therapy may bring greater clinical benefits.
METHODS: We conducted a systematic review and meta-analysis of studies evaluating the efficacy and safety of targeted therapy combined with antiangiogenic therapy in patients with brain metastases from NSCLC. Pooled odds ratios (ORs) and hazard ratios (HRs) were calculated to determine the overall effect of combination therapy on clinical outcomes.
RESULTS: Among the six included studies (n = 669), five studies used EGFR-TKI + Bevacizumab for combination therapy, and one study used EGFR-TKI + Endostar. Combination therapy significantly improved disease control rate (DCR) (OR = 3.98, 95 % CI: 2.56-6.18, p < 0.001) and response rate (RR) (OR = 6.63, 95 % CI: 2.89-15.22, p < 0.001) compared to controls. Progression-free survival (PFS) was markedly prolonged (HR = 0.52, 95 % CI: 0.39-0.69, p < 0.001), and overall survival (OS) improved significantly (HR = 5.75, 95 % CI: 3.22-10.29, p < 0.001). Subgroup analyses confirmed higher rates of hypertension and proteinuria when compared to targeted monotherapy (both p < 0.001). Other common adverse events showed no significant difference.
CONCLUSIONS: Targeted therapy combined with anti-angiogenesis treatment significantly enhances clinical outcomes in NSCLC patients with brain metastases, including DCR, RR, PFS, and OS. Nonetheless, this combination increases the risk of adverse events, necessitating careful management.
METHODS: We conducted a systematic review and meta-analysis of studies evaluating the efficacy and safety of targeted therapy combined with antiangiogenic therapy in patients with brain metastases from NSCLC. Pooled odds ratios (ORs) and hazard ratios (HRs) were calculated to determine the overall effect of combination therapy on clinical outcomes.
RESULTS: Among the six included studies (n = 669), five studies used EGFR-TKI + Bevacizumab for combination therapy, and one study used EGFR-TKI + Endostar. Combination therapy significantly improved disease control rate (DCR) (OR = 3.98, 95 % CI: 2.56-6.18, p < 0.001) and response rate (RR) (OR = 6.63, 95 % CI: 2.89-15.22, p < 0.001) compared to controls. Progression-free survival (PFS) was markedly prolonged (HR = 0.52, 95 % CI: 0.39-0.69, p < 0.001), and overall survival (OS) improved significantly (HR = 5.75, 95 % CI: 3.22-10.29, p < 0.001). Subgroup analyses confirmed higher rates of hypertension and proteinuria when compared to targeted monotherapy (both p < 0.001). Other common adverse events showed no significant difference.
CONCLUSIONS: Targeted therapy combined with anti-angiogenesis treatment significantly enhances clinical outcomes in NSCLC patients with brain metastases, including DCR, RR, PFS, and OS. Nonetheless, this combination increases the risk of adverse events, necessitating careful management.