The host defence peptide LL-37/hCAP-18 is a growth factor for lung cancer cells

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• 作者：Judith von Haussen ; Rembert Koczulla ; Renat Shaykhiev ; Christian Herr ; Olaf Pinkenburg ; Dietlind Reimer ; Rainer Wiewrodt ; Stefan Biesterfeld ; Achim Aigner ; Frank Czubayko ; Robert Bals
• 关键词：Non-small cell lung carcinoma ; Chemotherapy ; Cisplatin ; Carboplatin ; Platinum ; Meta-analysis ; Systematic review
• 刊名：Lung Cancer
• 出版年：2008
• 出版时间：January 2008
• 年：2008
• 卷：59
• 期：1
• 页码：12-23
• 全文大小：1007 K

文摘

Evidence suggests that platinum-based regimens confer a better survival in patients with non-small cell lung carcinoma (NSCLC). However, evidence is lacking regarding the specific effects of cisplatin or carboplatin when compared to non-platinum-based doublets.

Methods

Meta-analysis of all randomized trials comparing non-platinum-based with platinum-based doublet regimens given as first-line treatment for NSCLC. Relative risks were calculated for all outcomes ascertained. Sensitivity analysis, using methodological quality of the trials and different measures of effect, was undertaken.

Results

Seventeen trials, comprising 4920 patients were included. The use of platinum-based doublet regimens was associated with a slightly higher survival at 1 year (RR = 1.08, 95 % CI 1.01–1.16, p = 0.03), better partial response (RR = 1.11, 95 % CI 1.02–1.21, p = 0.02), with a higher risk of anemia, nausea, and neurotoxicity. Cisplatin-based doublet regimens improved survival at 1 year (RR = 1.16, 95 % CI 1.06–1.27, p = 0.001), complete response (RR = 2.29, 95 % CI 1.08–4.88, p = 0.03), partial response (RR = 1.19, 95 % CI 1.07–1.32, p = 0.002) with an increased risk of anemia, neutropenia, neurotoxicity and nausea. Conversely, carboplatin-based doublet regimens did not increase survival rate at 1 year (RR = 0.95, 95 % CI 0.85–1.07, p = 0.43). There was a statistically significant difference between the effect of cisplatin compared to carboplatin (p = 0.05). Carboplatin-based doublet regimen included a higher risk of anemia and thrombocytopenia, but no increased nausea and/or vomiting, contrarily to cisplatin. Sensitivity analyses showed that the results were robust to the exclusion of lesser quality trials and the choice of the measure of effect.

Conclusion

We provide additional evidence that cisplatin, but not carboplatin-based doublet regimens are associated with a slightly better survival compared to non-platinum-based doublet regimens. Side effects of cisplatin- and carboplatin-based regimens differ between each other and when compared to non-platinum doublets. Although this analysis has limitations, it may provide valuable information to clinicians when choosing the appropriate regimen for patients with non-small cell lung cancer.