Efficacy of intensified chemotherapy with hematopoietic progenitors in small-cell lung cancer: A meta-analysis of the published literature

Objective: It remains controversial whether intensified chemotherapy with hematopoietic progenitors (ICHP) is effective for small-cell lung cancer. This meta-analysis was performed to evaluate the efficacy and safety of ICHP in patients with small-cell lung cancer. Methods: MEDLINE and EMBASE databases were searched for English-language studies published through October 12, 2008. Randomized phase II and III clinical trials comparing ICHP with control therapy. Response rates, overall survival, and toxicity were analyzed. Results: Five assessable trials were identified including 641 patients. No significant increase in the odds ratio for response was attributable to ICHP (odds ratio, 1.29; 95% confidence interval, 0.87-1.93; p = 0.206). No statistically significant increase in overall survival was found when ICHP were compared to control regimens (hazard ratio, 0.94; 95% confidence interval, 0.80-1.10; p = 0.432). The toxicity of ICHP was significantly higher for hematologic toxicity, including hemoglobin nadir and platelet nadir. Conclusions: ICHP was not superior to control chemotherapy in terms of both objective response and overall survival, and was related to more significant hemoglobin nadir and platelet nadir. (C) 2008 Elsevier Ireland Ltd. All rights reserved.