A Systematic Review Of Clinical Efficacy And Safety Of Apatinib Combined With Chemotherapy For Advanced Non-small Cell Lung Cancer

Objective To investigate the efficacy and safety of apatinib combined with chemotherapy in patients with advanced non-small cell lung cancer,we used the method of meta analysis to analyze and discuss related research,and evaluated its short-term efficacy,quality of life,and adverse reactions for providing theoretical basis for clinical treatment,Methods Our study was conducted in accordance with the evidence-based medicine method and Cochrane Handook’s systematic review specifications.Searched PubMed,Embase,Cochrane library,Web Of Science,CNKI,Wanfang Database,and VIP,and then collected the randomized controlled trials about efficacy and safery of apatinib combined with chemotherapy in the treatment of advanced non-small cell lung cancer.The search time was set from the time that the database was established to February 5,2020.The literature treatment assessment method provided by Cochrane Handook and the improved Jadad quality assessment tool were used to evaluate the quality of the final included literature.After extracting the required data,statistical analysis was performed using Revman Manager 5.3software,and Stata 15.1 software was used to quantitatively verify and analyze the obtained publication bias.Results After literature search and strict comparison,17 randomized controlled trials that met the criteria were finally included,totaling 1,228 patients,612 in the apatinib combined chemotherapy group,and 616 in the chemotherapy control group.Meta analysis results show that apatinib combined with chemotherapy can significantly improve theobjective response rate [RR = 1.63,(95% CI: 1.41,1.88),P <0.00001],disease control rate[RR = 1.29,(95(% CI: 1.21,1.38),P <0.00001],quality of life(KPS score)[SMD =1.87,(95% CI: 1.38,2.37),P <0.00001] of patients,and significantly reducing CEA [MD =-2.64,(95% CI:-3.14,-2.13),P <0.00001],VEGF [SMD =-2.98,(95% CI:-3.91,-2.05),P <0.00001],CYFRA21-1 [MD =-1.54,(95% CI:-1.81,-1.26),P <0.00001] and MMP-9levels [SMD =-1.92,(95% CI:-3.03,-0.81),P = 0.0007] in patients.Apatinib combined with chemotherapy increased the incidence of abnormal blood pressure in patients [RR = 5.54,(95% CI: 3.06,10.03),P <0.00001].For other adverse reactions(proteinuria,blood toxicity,bone marrow suppression,liver dysfunction,gastrointestinal reaction,hand-foot syndrome),there was no significant difference between the two groups.Conclusion Compared with chemotherapy,apatinib combined with chemotherapy can significantly improve the clinical efficacy of advanced non-small cell lung cancer.In the resuts of adverse reactions,abnormal blood pressure is more significant,but patients can tolerate its adverse reactions,and the safety is better.