Kanglaite injection plus platinum-based chemotherapy for stage III/IV non-small cell lung cancer: A meta-analysis of 27 RCTs

Xiaoming Huang; Jue Wang; Wanjun Lin; Na Zhang; Jingjing Du; Ze Long; You Yang; Bowen Zheng; Fangfang Zhong; Qibiao Wu; Wenzhe Ma

doi:10.1016/j.phymed.2019.153154

Kanglaite injection plus platinum-based chemotherapy for stage III/IV non-small cell lung cancer: A meta-analysis of 27 RCTs

Phytomedicine. 2020 Feb:67:153154. doi: 10.1016/j.phymed.2019.153154. Epub 2019 Dec 19.

Authors

Xiaoming Huang¹, Jue Wang¹, Wanjun Lin¹, Na Zhang¹, Jingjing Du¹, Ze Long¹, You Yang¹, Bowen Zheng¹, Fangfang Zhong¹, Qibiao Wu², Wenzhe Ma³

Affiliations

¹ State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, PR China.
² State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, PR China. Electronic address: qbwu@must.edu.mo.
³ State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, PR China. Electronic address: wzma@must.edu.mo.

PMID: 31926475
DOI: 10.1016/j.phymed.2019.153154

Abstract

Background: Kanglaite injection (KLT) is a broad-spectrum anti-tumor drug, which is extracted from the seeds of the Chinese medicinal herb Coix lacryma-jobi, and has been widely used for the treatment of advanced lung cancer.

Purpose: To evaluate the combined effects of Kanglaite injection plus platinum-based chemotherapy (PBC) on patients with stage III/IV non-small cell lung cancer (NSCLC).

Study design: A systematic review and meta-analysis of randomized clinical trials (RCTs).

Materials and methods: Twelve databases were searched from their inceptions until July 05, 2019. All the RCTs comparing the efficacy and safety of Kanglaite injection plus PBC versus PBC alone were selected. Analyses were performed using Review Manager 5.3, Comprehensive Meta-Analysis 3.0 and Trial Sequential Analysis (TSA). Disease control rate (DCR) was defined as the primary endpoint, objective response rate (ORR), survival rate, quality of life (QOL), cellular immunity function, and toxicities were defined as the secondary endpoints.

Results: Twenty-seven RCTs recruiting 2,243 patients with stage III/IV NSCLC were included. The results showed that, compared with PBC alone, Kanglaite injection plus PBC improved DCR (RR = 1.20, 95% CI 1.15-1.26, p < 0.00001), ORR (RR = 1.45, 95% CI 1.31-1.60, p < 0.00001), 1-year survival rate (RR = 1.20, 95% CI 1.02-1.43, p = 0.03), QOL (RR = 1.32, 95% CI 1.25-1.40, p < 0.00001), CD4⁺T cells (WMD = 4.86, 95% CI 4.00-5.73, p < 0.00001), CD4⁺/CD8⁺ ratio (WMD = 0.19, 95% CI 0.07-0.31, p < 0.002), and reduced severe toxicities by 59% (RR = 0.41, 95% CI 0.33-0.51, p < 0.00001). Most results were robust and the quality of evidence was from moderate to low.

Conclusions: Kanglaite injection in combination with PBC showed significantly higher efficacy than PBC alone in the treatment of stage III/IV NSCLC. Moreover, the combination therapy can improve cellular immunity and attenuate the severe toxicities caused by chemotherapy. However, high-quality RCTs are warranted to further assess the effects of the combined therapy.

Keywords: Kanglaite injection; Meta-analysis; NSCLC; Platinum-based chemotherapy; Stage III/IV.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / adverse effects
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Carcinoma, Non-Small-Cell Lung / drug therapy*
Carcinoma, Non-Small-Cell Lung / mortality
Drugs, Chinese Herbal / administration & dosage
Humans
Injections
Lung Neoplasms / drug therapy*
Platinum Compounds / administration & dosage
Quality of Life
Randomized Controlled Trials as Topic
Survival Rate

Substances

Drugs, Chinese Herbal
Platinum Compounds
kang-lai-te