Objective For the dispute on the superiority of the pemetrexed compared with the docetaxel for treating advanced non-small-cell lung cancer (NSCLC), this study is conducted to evaluate the efficacy and safety of pemetrexed versus docetaxel for patients with NSCLC. Methods Such databases as The Cochrane Library, PubMed, EMBASE, SCI, CBM, CNKI, and VIP were searched to collect the randomized controlled trials (RCTs) about pemetrexed versus docetaxel for the treatment of NSCLC published before November of 2010. Two reviewers independently screened the studies, extracted the data and assessed the methodology quality. RevMan 5.0 software was used for meta-analyses. Results Five studies involving 847 patients were included. The results of meta-analyses showed that, in the aspect of efficacy, there was no significant difference between the two groups in the effective rate (OR=1.09, 95%CI 0.7 to 1.70), the disease control rate (OR=0.99, 95%CI 0.75 to 1.31), and the one-year survival rate (OR=1.11, 95%CI 0.56 to 2.18); in the aspect of safety, compared with docetaxel, pemetrexed could reduce the neutropenia (OR=0.09, 95%CI 0.05 to 0.15), the febrile neutropenia (OR=0.13, 95%CI 0.06 to 0.29) and the alopecia (OR=0.20, 95%CI 0.12 to 0.33), but no significant difference was found in haemoglobin (OR=1.45, 95%CI 0.23 to 9.06), thrombocytopenia (OR=1.46, 95%CI 0.59 to 3.59), nausea and vomiting (OR=1.23, 95%CI 0.53 to 2.83) and fatigue and debilitation (OR=0.73, 95%CI 0.40 to 1.30). Conclusion As the current evidence shows, pemetrexed has similar efficacy to docetaxel for advanced NSCLC patients, but it has fewer side effects of neutropenia, febrile neutropenia and alopecia.
Objectives To evaluate the clinical effectiveness and safety of combined induction therapy of interferon (IFN) with chemotherapy for survival of the patients with advanced non-small cell lung cancer (NSCLC) by meta-analysis. Methods All clinical trials of addition of IFN plus chemotherapy versus chemotherapy alone for induction therapy to advanced NSCLC patients in MEDLINE (1966-2006), EMBASE (1984-2006.1) and The Cochrane Library (Issue 1,2006) were identified. The references of related studies and Education Books of ASCO and ESMO meeting were handsearched. The quality of included trials was evaluated. Data were extracted by two reviewers independently with a designed extraction form. RevMan 4.2.7 software was used for data analysis. Results Five randomized controlled trials involving 360 patients were included. The pooled result of 3 studies showed that IFN plus chemotherapy induction treatment did not improve 1-year survival rate with RR 0.76, 95%CI 0.46 to 1.26. The pooled result of 5 studies showed that IFN plus chemotherapy induction treatment did not improve response rate with RR 1.40, (0.83 2.34). The pooled result showed that IFN plus chemotherapy induction treatment might significantly increase leukopenia and thrombocytopenia with RR 2.61,95%CI1.70 to 3.99) and RR 4.78,95%CI 1.87 to 12.19 respectively . Conclusion Insufficient data exists to state whether IFN plus chemotherapy induction treatment can improve 1-year survival rate and response rate. IFN plus chemotherapy may increase occurrence of leucopenia and thrombocytopenia. Further studies are warranted.