Meta-analysis of Maintenance Therapy With Interferon for Small Cell Lung Cancer_Chinese Journal of Evidence-Based Medicine

Authors：

HU Xuejun ¹ , JIN Bo ² ,  LIU Yunpeng ² , ZHANG Jing ³ , SHI Jingpu ³

1. Department of Respiratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, China 2. Department of Medical Oncology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China 3. Department of Epidemiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China;

Corresponding author：

LIU Yunpeng, Email: liuyunpeng@csco.org.cn

Keywords：

Small cell lung cancer (SCLC); Interferon; Maintenance therapy; Meta-analysis

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Objectives 　To evaluate the efficacy of interferon (IFN) maintenance therapy in patients with small cell lung cancer (SCLC).
Methods 　We searched MEDLINE (1966-Jan.2006), EMbase (1984-Jan.2006), The Cochrane Library(Issue 1, 2006)and the Chinese Biomedical Database (1980-Jan.2006). We checked the references in the reports of related studies and handsearched the education books of ASCO and ESMO meetings. The quality of the included trials was evaluated. Data were extracted by two reviewers independently into a specially designed extraction form. The Cochrane Collaboration’s RevMan 4.2.7 software was used for data analysis.
Results 　Five randomized controlled trials involving 587 patients were included. The pooled result of the 5 studies showed that IFN plus chemotherapy induction treatment did not have a significant effect on 1-year (RR 1.19, 95%CI 0.88-1.6) or 2-year survival rate (RR 1.44, 95% CI 0.99-2.10). However, IFN maintenance therapy significantly increased 2-year (RR 2.08, 95%CI 1.16-3.72) and 1-year survival (RR 2.99, 95%CI 1.13-7.93).
Conclusion 　IFN maintenance therapy may increase 2-year and 1-year survival rates after patients have achieved complete or partial response to chemotherapy. Further randomized, double-blind multi-center trials are needed to investigate this further.

Citation： HU Xuejun,JIN Bo,LIU Yunpeng,ZHANG Jing,SHI Jingpu. Meta-analysis of Maintenance Therapy With Interferon for Small Cell Lung Cancer. Chinese Journal of Evidence-Based Medicine, 2006, 06(11): 809-814. doi: Copy

1.	王吉耀. 主编. 循证医学与临床实践. 第1版. 北京: 科学出版社; 2002. 55~81, 86~121.
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7.	Laurie SA, Logan D, Markman BR, et al. Practice guideline for the role of combination chemotherapy in the initial management of limited-stage small-cell lung cancer. Lung Cancer, 2004; 43(2): 223–240.
8.	Mattson K, Niiranen A, Pyrhonen S, et al. Natural interferon alfa as maintenance therapy for small cell lung cancer. Eur J Cancer, 1992; 28A(8-9): 1387–1391.
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11.	Jett JR, Maksymiuk AW, Su JQ, et al. Phase III trial of recombinant interferon gamma in complete responders with small-cell lung cancer. J Clin Oncol, 1994; 12(11): 2321–2326.
12.	van Zandwijk N, Groen HJ, Postmus PE, et al. Role of recombinant interferon-gamma maintenance in responding patients with small cell lung cancer. A randomised phase III study of the EORTC Lung Cancer Cooperative Group. Eur J Cancer, 1997; 33(11): 1759–1766.
13.	Mattson K, Niiranen A, Ruotsalainen T, et al. Interferon maintenance therapy for small cell lung cancer: improvement in long-term survival. J Interferon Cytokine Res, 1997; 17(2): 103–105.
14.	Kelly K, Crowley JJ, Bunn PA Jr, et al. Role of recombinant interferon alfa-2a maintenance in patients with limited-stage small-cell lung cancer responding to concurrent chemoradiation: a Southwest Oncology Group study. J Clin Oncol, 1995; 13(12): 2924–2930.
15.	Wang JY. Chief Editor. Evidence-Based Medicine and Clinical Practice. 1st edition. Beijing: Science Press; 2002. 55–81, 86–121.
16.	Zhu XS, Shao L. Immune status of lung cancer patients and immunotherapy of lung cancer. Chinese J. Lung Cancer, 2000; 3(2): 158–160.
17.	Tagliaferri P, Caraglia M, Budillon A. New pharmacokinetic and pharmacodynamic tools for interferon-alpha (IFN-alpha) treatment of human cancer. Cancer Immunol Immunother, 2005; 54(1): 1–10.
18.	Matsumoto K, Okano J, Murawaki Y. Differential effects of interferon alpha-2b and beta on the signaling pathways in human liver cancer cells. J Gastroenterol, 2005; 40(7): 722–732.
19.	Zika E, Fauquier L, Vandel L, et al. Interplay among coactivator-associated arginine methyltransferase 1, CBP, and CIITA in IFN-gamma-inducible MHC-II gene expression. Proc Natl Acad Sci USA, 2005; 102(45): 16321–16326.
20.	Ruotsalainen TM, Mattson K. Interferon trials in small cell lung cancer at one institution: a comparison of results obtained before and after initiation of systematic treatment trials using IFN-alpha in combination with other modalities. J Interferon Cytokine Res, 2002; 22(2): 165–171.
21.	Jones DH, Bleehen NM, Slater AJ, et al. Human lymphoblastoid interferon in the treatment of small cell lung cancer. Br J Cancer, 1983; 47(3): 361–366.
22.	Villar J, Carroli G, Belizan JM. Predictive ability of meta-analyses of randomised controlled trials. Lancet, 1995, 345(8952): 772–776.
23.	Zhang MM, Li J. Evidence-based medicine: from a point of view of patient. Medicine and Philosophy, 2005; 26(8): 55–56.

1. 王吉耀. 主编. 循证医学与临床实践. 第1版. 北京: 科学出版社; 2002. 55~81, 86~121.
2. 朱晓松, 邵黎. 肺癌患者的免疫状态及肺癌的免疫治疗. 中国肺癌杂志, 2000; 3(2): 158~160.
3. 张鸣明, 李静. 从患者角度看循证医学. 医学与哲学, 2005; 26(8): 55~56.
4. Ihde DC, Pass HI, Glastein E. Small cell lung cancer. In: De Vita VT Jr, Hellman S, Rosenberg SA(eds). Cancer Principles and Practice of Oncology, 5th ed. Philadelphia: Lippincott-Raven; 1997. 911–949.
5. Carney DN, Shepherd FA. Treatment of SCLC: Chemotherapy, in Hansen HH: Textbook of Lung cancer. London, Martin Donitz LTD; 2000. 261–272.
6. Feld R, Evans WK, DeBoer G, et al. Combined modality induction therapy without maintenance chemotherapy for small cell carcinoma of the lung. J Clin Oncol, 1984; 2(4): 294–304.
7. Laurie SA, Logan D, Markman BR, et al. Practice guideline for the role of combination chemotherapy in the initial management of limited-stage small-cell lung cancer. Lung Cancer, 2004; 43(2): 223–240.
8. Mattson K, Niiranen A, Pyrhonen S, et al. Natural interferon alfa as maintenance therapy for small cell lung cancer. Eur J Cancer, 1992; 28A(8-9): 1387–1391.
9. Lebeau B, Delasalamoniere P, Ozeanne G, et al. alpha Interferon (alpha-IFN) as maintenance therapy for small cell lung cancer(SCLC). J Clin Oncol, 1999; 17(suppl): 1832.
10. Ruotsalainen T, Halme M, Isokangas OP, et al. Interferon-alpha and 13-cis-retinoic acid as maintenance therapy after high-dose combination chemotherapy with growth factor support for small cell lung cancer--a feasibility study. Anticancer Drugs, 2000; 11(2): 101–108.
11. Jett JR, Maksymiuk AW, Su JQ, et al. Phase III trial of recombinant interferon gamma in complete responders with small-cell lung cancer. J Clin Oncol, 1994; 12(11): 2321–2326.
12. van Zandwijk N, Groen HJ, Postmus PE, et al. Role of recombinant interferon-gamma maintenance in responding patients with small cell lung cancer. A randomised phase III study of the EORTC Lung Cancer Cooperative Group. Eur J Cancer, 1997; 33(11): 1759–1766.
13. Mattson K, Niiranen A, Ruotsalainen T, et al. Interferon maintenance therapy for small cell lung cancer: improvement in long-term survival. J Interferon Cytokine Res, 1997; 17(2): 103–105.
14. Kelly K, Crowley JJ, Bunn PA Jr, et al. Role of recombinant interferon alfa-2a maintenance in patients with limited-stage small-cell lung cancer responding to concurrent chemoradiation: a Southwest Oncology Group study. J Clin Oncol, 1995; 13(12): 2924–2930.
15. Wang JY. Chief Editor. Evidence-Based Medicine and Clinical Practice. 1st edition. Beijing: Science Press; 2002. 55–81, 86–121.
16. Zhu XS, Shao L. Immune status of lung cancer patients and immunotherapy of lung cancer. Chinese J. Lung Cancer, 2000; 3(2): 158–160.
17. Tagliaferri P, Caraglia M, Budillon A. New pharmacokinetic and pharmacodynamic tools for interferon-alpha (IFN-alpha) treatment of human cancer. Cancer Immunol Immunother, 2005; 54(1): 1–10.
18. Matsumoto K, Okano J, Murawaki Y. Differential effects of interferon alpha-2b and beta on the signaling pathways in human liver cancer cells. J Gastroenterol, 2005; 40(7): 722–732.
19. Zika E, Fauquier L, Vandel L, et al. Interplay among coactivator-associated arginine methyltransferase 1, CBP, and CIITA in IFN-gamma-inducible MHC-II gene expression. Proc Natl Acad Sci USA, 2005; 102(45): 16321–16326.
20. Ruotsalainen TM, Mattson K. Interferon trials in small cell lung cancer at one institution: a comparison of results obtained before and after initiation of systematic treatment trials using IFN-alpha in combination with other modalities. J Interferon Cytokine Res, 2002; 22(2): 165–171.
21. Jones DH, Bleehen NM, Slater AJ, et al. Human lymphoblastoid interferon in the treatment of small cell lung cancer. Br J Cancer, 1983; 47(3): 361–366.
22. Villar J, Carroli G, Belizan JM. Predictive ability of meta-analyses of randomised controlled trials. Lancet, 1995, 345(8952): 772–776.
23. Zhang MM, Li J. Evidence-based medicine: from a point of view of patient. Medicine and Philosophy, 2005; 26(8): 55–56.

Chinese Journal of Evidence-Based Medicine

Meta-analysis of Maintenance Therapy With Interferon for Small Cell Lung Cancer

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