Thymosin plus cisplatin with vinorelbine or gemcitabine for non-small cell lung cancer: A systematic review and meta-analysis of randomized controlled trials

Objective: To evaluate the efficacy and safety of thymosin plus cisplatin with vinorelbine (NP)/gemcitabine with cisplatin (GP) program for patients with non-small cell lung cancer (NSCLC). Methods: We searched PubMed, EMBASE, Cochrane Library, ISI Web of Knowledge, Chinese Biomedical Database and other databases. Randomized controlled trials (RCT) comparing thymosin plus NP/GP with NP/GP alone for patients with NSCLC were eligible for our study. We evaluated the quality of included studies using Cochrane Handbook standards. Data analysis was conducted using Review Manager 5.0 software (The Nordic Cochrane Centre, Copenhagen, Denmark). Results: Ten RCT including 724 patients were eligible. The results of our study showed that: compared with an NP program alone, thymosin plus NP could increase overall response rate (odds ratio (OR) 1.86; 95% confidence interval (CI) 1.08-3.20), tumor control rate (OR 3.06; 95% CI: 1.36-6.88) and 1-year survival rate (OR 3.05; 95% CI: 1.34-6.96), improve the quality of life (OR 3.39; 95% CI: 1.54-7.47), CD4 (mean difference (MD) 6.7; 95% CI: 3.52-9.88) and NK cells (MD 6.53; 95% CI: 3.6-9.47). Compared with a GP program alone, thymosin plus GP could increase overall response rate (OR 1.67; 95% CI: 1.09-2.55), tumor control rate (OR 2.38; 95% CI: 1.01-5.62), improve quality of life (OR 3.84; 95% CI: 1.97-7.48), CD4 (MD 14.82; 95% CI: 8.05-21.59) and NK (MD 16.96; 95% CI: 4.90-29.03) Conclusion: Thymosin plus NP/GP is a better choice for patients with advanced NSCLC than NP/GP alone.