Overall Survival Prediction of Docetaxel-based Second-line Treatment for Advanced Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis

OBJECTIVES: Non-small cell lung cancer (NSCLC) accounts for 75–85% of all lung cancer diagnoses. This meta-analysis sought to estimate the overall survival (OS) of NSCLC based on randomized control trials which had compared docetaxel with kinase inhibitors, antineoplastic agents, and monoclonal antibodies as second-line chemotherapy for advanced NSCLC. METHODS: We selected 18 randomized control trials which used docetaxel as the standard treatment arm, while kinase inhibitors, antineoplastic agents, and monoclonal antibodies constituted the experimental arm. The methodological quality of the trial was classified according to the Modified Jadad score. Several steps were taken to reduce publication bias. A forest plot was used to graphically summarize the meta-analysis. RESULTS: The Hedge’s g value of antineoplastic agents was 0.11 (95% CI: -0.03–0.26), while for kinase inhibitors was 0.04 (95% CI: -0.10–0.17) and monoclonal antibodies was 0.05 (95% CI: -0.02–0.13). Forest plot showed a clear though only slightly higher overall survival using docetaxel compared to those of the antineoplastic agents, kinase inhibitors, and monoclonal antibodies, due to the existence of moderate heterogeneity and lower impact. CONCLUSIONS: Overall, the patients in these studies who were in the standard (docetaxel) treatment arm had slightly better OS than those in the intervention treatment arm. As per the results, docetaxel was more effective in the second-line treatment of advanced NSCLC than antineoplastic agents, monoclonal antibodies, and kinase inhibitors. We infer that docetaxel-based second-line therapy for patients with advanced NSCLC is supported by our meta-analysis.