Objective To evaluate the effectiveness and safety of Endostar combined with chemotherapy for non-small cell lung cancer (NSCLC). Methods Randomized controlled trials (RCTs) on Endostar combined with chemotherapy for NSCLC were searched in The Cochrane Library, MEDLINE, EMbase, VIP, CNKI, CBMdisc and other electronic databases. The quality of RCTs meeting inclusion criteria was evaluated and the data were extracted; meta-analyses were performed with RevMan 5.1 software, and then the GRADE System was used to rate the level of evidence and strength of recommendation. Results Among the 18 RCTs involving 1 825 cases included, 1 816 cases met the inclusion criteria. Meta-analyses showed that: compared with the single chemotherapy, Endostar combined with chemotherapy could increase the total effective rate (RR=1.85, 95%CI 1.56 to 2.11, Plt;0.000 01), and the clinical benefit response (RR=1.21, 95%CI 1.14 to 1.29, Plt;0.000 01), but decrease the incidence risk of leukopenia (RR=0.89, 95%CI 0.82 to 0.97, P=0.006). There were no signficant differences between the two groups in decreasing thrombocytopenia (RR=0.87, 95%CI 0.74 to 1.03, P=0.10), impaired renal function (RR=0.96, 95%CI 0.69 to 1.34, P=0.82), nausea and vomiting (RR=0.92, 95%CI 0.84 to 1.01, P=0.08) and other side effects. Based on GRADE, the level of evidence was Grade C, and the strength of recommendation was 2. Conclusion The present results of clinical trials show that Endostar combined with chemotherapy for NSCLC is a safe and effective therapy without increasing the toxic reaction and side effects; and based on GRADE, the level of evidence was Grade 2C, and the strength of recommendation was 2. However, in view of the limitations of this study, it is suggested that large-scale, high-quality researches on basic and clinical fields should be performed to further verify the above conclusion by critical outcome indicators.
Objective To overview the systematic reviews of recombinant human endostatin combined with platinum compounds for malignant pleural effusion (MPE). Methods According to the inclusion and exclusion criteria and searching strategies, we screened the systematic reviews of recombinant human endostatin combined with platinum compounds for the treatment of MPE by searching the Embase, PubMed, Clinical Trials, Cochrane Library, China National Knowledge Infrastructure, CQVIP Database and Wanfang Database. The searching time was from January 1999 to December 2021. The methodological quality was evaluated using AMSTAR 2 tool, the report quality was evaluated using PRISMA statement, and the evidence quality of the outcome indicators was graded according to the GRADE system. Finally, RevMan 5.3 software was used to quantitatively merge and analyze the original research effect values of the main outcome indicators with low level of evidence. Results A total of 9 systematic reviews/meta-analyses involving 8 outcome indicators and totally 50 outcomes were included. The average PRISMA scale score was 22.28±1.37, with 6 reports being relatively complete and 3 reports having certain reporting defects. The overall methodological quality of the 9 systematic reviews was extremely low. Most of the 50 outcomes were graded as “low” (31 outcomes) or “intermediate” (18 outcomes) quality. The results of 9 systematic reviews all showed that the clinical efficacy of dual therapy was more satisfactory than that of platinum-based preparations in the treatment of MPE, and re-quantitative analysis also confirmed that there was no statistically significant difference in the incidence of adverse events between the two treatments (P>0.05). Conclusions Considering the existing evidence and the results of meta-analysis, the dual therapy composed of recombinant human endostatin and platinum compounds is more effective in the treatment of MPE, and there is no difference in the incidence of related adverse events. However, because of its poor methodological quality and the low level of evidence, the above conclusions can only provide a certain reference and need to be confirmed by further research.