A meta-analysis of Pemetrexed plus Platinum Chemotherapy versus Gemcitabine plus Platinum Chemotherapy for Advanced Non-small Cell Lung Cancer

Abstract

Background and objective Whether pemetrexed plus platinum (PP) regimen is superior to gemcitabine plus platinum (GP) regimen for patients with advanced non-small cell lung cancer (NSCLC) is unclear. The aim of this study is to evaluate the efficacy and safety of PP versus GP regimens for patients with NSCLC. Methods We searched relevant randomized controlled trials (RCTs) from Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, and traced the related references to obtain the information that has not been found. We made quality assessment of qualified RCTs assessed by the exclusion and inclusion criteria and used RevMan 5.0 provided by the Cochrane Collaboration to perform meta-analysis. Results Four RCTs involving 2,235 patients were identified. There were no statistical differences between PP and GP regimens in one-year survival rate (OR=1.09, 95%CI: 0.91-1.29), the efficiency of disease (OR=1.00, 95%CI: 0.40-2.52), but overall survival (MD=0.26, 95%CI: 0.21-0.30), alopecia (OR=0.51, 95%CI: 0.39-0.66) and hematologic toxicity were significantly different. Conclusion The clinical efficiency of PP and GP regimens for advanced NSCLC was similar, but the side effects were different. The toxicity of PP regimen has the tendency to be more tolerable