Abstract | BACKGROUND: METHODS: We carried out standard meta-analysis and network meta-analysis based on a comprehensive data retrieval of EMBASE, PubMed, and Cochrane Library databases (up to March 2019). Random and fixed effects models were used where indicated and between-study heterogeneity was assessed. The primary endpoints were overall survival (OS) and skeletal-related events (SREs). The second endpoints were progression-free survival (PFS) and overall response rate (ORR). RESULTS: Seven randomized clinical trials, including 1426 NSCLC patients with seven studies of zoledronic acid and two studies of strontium-89, met the inclusion criteria. Compared with the control group, ZA is associated with a OS benefit (1-year survival rate: RR = 1.76, 95% CI 1.36-2.27; and 24-month survival rate: RR = 2.38, 95% CI 1.35-4.19) and a reduction of SREs (RR = 0.57, 95% CI 0.40-0.84) for the patients with bone metastases. No statistical differences were found in PFS and ORR. Network meta-analysis for the patients with bone metastases showed that ZA + strontium-89 and ZA harbored significantly clinical benefits than strontium-89 and placebo in terms of 1-year survival rate and SREs. Both head-to-head study and network meta-analysis showed that strontium-89 had no statistical impact on OS and SREs compared with placebo. CONCLUSION: Our analysis demonstrates that ZA +strontium-89 can be considered a priority for NSCLC patients with bone metastases, followed by ZA.
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Authors | Zhigang Hu, Yufeng Tian, Wenxin Li, Yushu Ruan, Fanjun Zeng |
Journal | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
(Support Care Cancer)
Vol. 28
Issue 7
Pg. 3291-3301
(Jul 2020)
ISSN: 1433-7339 [Electronic] Germany |
PMID | 31754835
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Chemical References |
- Bone Density Conservation Agents
- Strontium Radioisotopes
- Strontium-89
- Zoledronic Acid
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Topics |
- Bone Density Conservation Agents
(pharmacology, therapeutic use)
- Carcinoma, Non-Small-Cell Lung
(drug therapy, mortality)
- Humans
- Randomized Controlled Trials as Topic
- Strontium Radioisotopes
(pharmacology, therapeutic use)
- Survival Analysis
- Zoledronic Acid
(pharmacology, therapeutic use)
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