Efficacy and safety of anlotinib combined with etoposide and platinum-based regimens in the first-line treatment of extensive-stage small-cell lung cancer: a systematic review and meta-analysis

Background: The use of anlotinib as a third-line or subsequent treatment for extensive-stage small-cell lung cancer (ES-SCLC) has been studied. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of anlotinib combined with etoposide and platinum-based regimens in the first-line treatment of ES-SCLC. Methods: A systematic search was conducted on PubMed, Embase, Cochrane Library, and Web of Science databases. Studies investigating the efficacy of anlotinib combined with etoposide and platinum-based regimens in the first-line treatment of ES-SCLC were analysed. The results of these studies were summarized and meta-analyzed to calculate combined survival measures with 95% confidence intervals. Results: The meta-analysis included seven studies with a total of 519 cases. Regarding tumour response, the pooled objective response rate was 83.0%. Based on survival analysis, the pooled median progression-free survival and overall survival were 7.29 and 14.99 months, respectively. The most common treatment-related adverse events of anlotinib in combination with etoposide and platinum-based therapy were hypertension (all-grades: 28.4%, grade ≥3: 3.7%), decreased white blood cell count (all-grades: 27.2%, grade ≥3: 6.3%), and fatigue (all-grades: 27.2%, grade ≥3: 3.7%). Conclusions: This meta-analysis demonstrated that anlotinib in combination with etoposide and platinum-based regimens has potentially promising efficacy and safety in the first-line treatment of ES-SCLC. However, more randomized controlled trials are still needed to verify these findings.