Efficacy And Safety Assessment Of Apatinib In Patients With Advanced Non-Small Cell Lung Cancer:A Meta-Analysis

Objective: The morbidity and mortality of lung cancer have been ranked the first among malignant tumors in China.Apatinib,as a new oral small-molecule anti-angiogenic drug independently developed in China,has been approved for the treatment of advanced gastric cancer and achieved significant efficacy.In recent years,apatinib has been increasingly used in the treatment of advanced lung cancer,and has shown some anti-tumor efficacy.In this study,the efficacy and safety of oral apatinib in patients with advanced non-small cell lung cancer(NSCLC)were investigated by Meta analysis.Methods: Randomized controlled trials on efficacy and safety of apatinib in the treatment of advanced NSCLC were collected through computer retrieval of PubMed,EMBASE,CNKI,wanfang and other databases,and the retrieval time was limited from the establishment of the database to September 2018.Relevant data were extracted and Meta analysis was performed using Stata12.0 software.Results: A total of 13 RCTs involving 893 patients were included.Meta analysis results showed that compared with the control group,apatinib treatment group could improve overall response rate(RR=1.39,95%CI:1.25-1.55,P<0.001)and disease control rate(RR=1.24,95%CI:1.07-1.44,P<0.05).At the same time,the patients' quality of life was improved(SMD=1.44,95%CI : 0.56 ~ 2.31,P=0.001).The level of VEGF(SMD=-5.98,95%CI:-11.05~-0.92,P=0.021),MMP-9(SMD=-6.46,95%CI:-10.68~-2.25,P=0.003)and CEA(SMD=-2.46,95%CI:-2.85~-2.08,P=0.001)were decreased.In terms of safety,the apatinib group increased the incidence of hypertension(RR=4.71,95%ci: 1.06-20.91,P<0.05),but other AEs were no significant difference(P>0.05).Conclusion: Current research evidence shows that apatinib can improve the clinical efficacy of advanced non-small cell lung cancer compared with traditional treatment.The main adverse reactions were hypertension,but it were tolerable.