Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-Analysis
IntroductionA modified and recombinant human endostatin (Rh-endostatin) is often used in the control of malignant pleural effusion (MPE) through intrapleural infusion.ObjectivesTo demonstrate the clinical response, survival, and safety of Rh-endostatin plus chemical irritants, their optimal combinat...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-08-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.649999/full |
| _version_ | 1830448061802872832 |
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| author | Cheng-Qiong Wang Cheng-Qiong Wang Xiao-Rong Huang Min He Xiao-Tian Zheng Xiao-Tian Zheng Hong Jiang Hong Jiang Qian Chen Teng-Yan Fan Teng-Yan Fan Lin Zhan Juan Ling Ji-Hong Feng Xue Xiao Xue Xiao Xiao-Fan Chen Zheng Xiao Zheng Xiao |
| author_facet | Cheng-Qiong Wang Cheng-Qiong Wang Xiao-Rong Huang Min He Xiao-Tian Zheng Xiao-Tian Zheng Hong Jiang Hong Jiang Qian Chen Teng-Yan Fan Teng-Yan Fan Lin Zhan Juan Ling Ji-Hong Feng Xue Xiao Xue Xiao Xiao-Fan Chen Zheng Xiao Zheng Xiao |
| author_sort | Cheng-Qiong Wang |
| collection | DOAJ |
| description | IntroductionA modified and recombinant human endostatin (Rh-endostatin) is often used in the control of malignant pleural effusion (MPE) through intrapleural infusion.ObjectivesTo demonstrate the clinical response, survival, and safety of Rh-endostatin plus chemical irritants, their optimal combinations, treatment threshold, and optimal usage, we performed a new systematic review and meta-analysis.MethodologyAll randomized controlled trials (RCTs) were collected from Chinese and English electronic databases (from inception until August 2020). We pooled the data using a series of meta-analyses and summarized the evidence quality following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsWe included 75 RCTs recruiting 4,678 patients, which reported six combinations for Rh-endostatin plus chemical irritants. Among the six combinations, only Rh-endostatin plus cisplatin (DDP) with enough trials might improve the complete response [2.29 (1.93, 2.71)] and quality of life [3.01 (2.49, 3.63)] and reduce treatment failure [0.29 (0.25, 0.33)] and progressive disease [0.27 (0.22, 0.34)]. It might not increase the risk of adverse drug reactions. For patients with lung cancer, moderate to massive effusion, initial treatment, Karnofsky Performance Status (KPS) score ≥60, or anticipated survival time ≥3 months, Rh-endostatin (30–45 mg each time, once or twice a week 3–4 times) plus DDP (30–60 mg/m2) obtained a significant improvement in clinical response and a reduction of failure and progressive disease. Most results had good robustness and moderate quality.ConclusionsCurrent evidence suggests that Rh-endostatin with DDP may be an optimal combination, which may improve clinical response and reduce failure and progressive disease with good safety. Rh-endostatin (30–40 mg each time, once or twice a week 3–4 times) with DDP (30–40 mg/m2) may be an optimal usage for achieving an ideal response. |
| first_indexed | 2024-12-21T07:33:46Z |
| format | Article |
| id | doaj.art-83a1e16ac21441f99009e623b7dc733d |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-21T07:33:46Z |
| publishDate | 2021-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-83a1e16ac21441f99009e623b7dc733d2022-12-21T19:11:30ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-08-011110.3389/fonc.2021.649999649999Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-AnalysisCheng-Qiong Wang0Cheng-Qiong Wang1Xiao-Rong Huang2Min He3Xiao-Tian Zheng4Xiao-Tian Zheng5Hong Jiang6Hong Jiang7Qian Chen8Teng-Yan Fan9Teng-Yan Fan10Lin Zhan11Juan Ling12Ji-Hong Feng13Xue Xiao14Xue Xiao15Xiao-Fan Chen16Zheng Xiao17Zheng Xiao18Department of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Center, MOE Virtual Research Center of Evidence-based Medicine at Zunyi Medical College, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaGCP Center, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Center, MOE Virtual Research Center of Evidence-based Medicine at Zunyi Medical College, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Center, MOE Virtual Research Center of Evidence-based Medicine at Zunyi Medical College, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Nanchang, ChinaDepartment of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Center, MOE Virtual Research Center of Evidence-based Medicine at Zunyi Medical College, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaLaboratory Research Center, Guizhou Provincial People’s Hospital, Guizhou University, Guiyang, ChinaDepartment of Infection Management, Gansu Provincial People’s Hospital, Lanzhou, ChinaDepartment of Oncology, Lishui People’s Hospital, Sixth Affiliated Hospital of Wenzhou Medical University, Lishui, ChinaDepartment of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Center, MOE Virtual Research Center of Evidence-based Medicine at Zunyi Medical College, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Nanchang, ChinaDepartment of General Practice, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaEvidence-Based Medicine Center, MOE Virtual Research Center of Evidence-based Medicine at Zunyi Medical College, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaIntroductionA modified and recombinant human endostatin (Rh-endostatin) is often used in the control of malignant pleural effusion (MPE) through intrapleural infusion.ObjectivesTo demonstrate the clinical response, survival, and safety of Rh-endostatin plus chemical irritants, their optimal combinations, treatment threshold, and optimal usage, we performed a new systematic review and meta-analysis.MethodologyAll randomized controlled trials (RCTs) were collected from Chinese and English electronic databases (from inception until August 2020). We pooled the data using a series of meta-analyses and summarized the evidence quality following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsWe included 75 RCTs recruiting 4,678 patients, which reported six combinations for Rh-endostatin plus chemical irritants. Among the six combinations, only Rh-endostatin plus cisplatin (DDP) with enough trials might improve the complete response [2.29 (1.93, 2.71)] and quality of life [3.01 (2.49, 3.63)] and reduce treatment failure [0.29 (0.25, 0.33)] and progressive disease [0.27 (0.22, 0.34)]. It might not increase the risk of adverse drug reactions. For patients with lung cancer, moderate to massive effusion, initial treatment, Karnofsky Performance Status (KPS) score ≥60, or anticipated survival time ≥3 months, Rh-endostatin (30–45 mg each time, once or twice a week 3–4 times) plus DDP (30–60 mg/m2) obtained a significant improvement in clinical response and a reduction of failure and progressive disease. Most results had good robustness and moderate quality.ConclusionsCurrent evidence suggests that Rh-endostatin with DDP may be an optimal combination, which may improve clinical response and reduce failure and progressive disease with good safety. Rh-endostatin (30–40 mg each time, once or twice a week 3–4 times) with DDP (30–40 mg/m2) may be an optimal usage for achieving an ideal response.https://www.frontiersin.org/articles/10.3389/fonc.2021.649999/fullendostatinrecombinant human endostatin (Rh-endostatin)chemical irritantscisplatinoptimal adjuvant strategymeta-analysis |
| spellingShingle | Cheng-Qiong Wang Cheng-Qiong Wang Xiao-Rong Huang Min He Xiao-Tian Zheng Xiao-Tian Zheng Hong Jiang Hong Jiang Qian Chen Teng-Yan Fan Teng-Yan Fan Lin Zhan Juan Ling Ji-Hong Feng Xue Xiao Xue Xiao Xiao-Fan Chen Zheng Xiao Zheng Xiao Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-Analysis Frontiers in Oncology endostatin recombinant human endostatin (Rh-endostatin) chemical irritants cisplatin optimal adjuvant strategy meta-analysis |
| title | Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-Analysis |
| title_full | Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-Analysis |
| title_fullStr | Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-Analysis |
| title_short | Intrapleural Administration With Rh-Endostatin and Chemical Irritants in the Control of Malignant Pleural Effusion: A Systematic Review and Meta-Analysis |
| title_sort | intrapleural administration with rh endostatin and chemical irritants in the control of malignant pleural effusion a systematic review and meta analysis |
| topic | endostatin recombinant human endostatin (Rh-endostatin) chemical irritants cisplatin optimal adjuvant strategy meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.649999/full |
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