Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-Analysis
<b>Background/Objectives</b>: Non-small-cell lung cancer (NSCLC) frequently metastasizes to the brain, significantly impacting patient prognosis and quality of life. Anlotinib, a novel tyrosine kinase inhibitor, has shown promise in treating NSCLC with brain metastasis. So, we aimed to e...
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2025-06-01
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| author | Helal F. Hetta Mostafa A. Sayed Ali Saleh F. Alqifari Hoda A. Salem Khulood A. Qasem Fawaz E. Alanazi Amirah Alhowiti Amirah M. Alatawi Hyder Mirghani Tariq Alrasheed Salwa Q. Bukhari Khalid A. Almazyad Sultan A. Alhumaid Noura H. Abd Ellah Hashim M. Aljohani Yasmin N. Ramadan Reem Sayad |
| author_facet | Helal F. Hetta Mostafa A. Sayed Ali Saleh F. Alqifari Hoda A. Salem Khulood A. Qasem Fawaz E. Alanazi Amirah Alhowiti Amirah M. Alatawi Hyder Mirghani Tariq Alrasheed Salwa Q. Bukhari Khalid A. Almazyad Sultan A. Alhumaid Noura H. Abd Ellah Hashim M. Aljohani Yasmin N. Ramadan Reem Sayad |
| author_sort | Helal F. Hetta |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Non-small-cell lung cancer (NSCLC) frequently metastasizes to the brain, significantly impacting patient prognosis and quality of life. Anlotinib, a novel tyrosine kinase inhibitor, has shown promise in treating NSCLC with brain metastasis. So, we aimed to evaluate the clinical efficacy of anlotinib and various types of radiotherapy combinations used to treat NSCLC patients with brain metastasis regarding overall survival and the treatment of internal and external lesions. <b>Methods</b>: A comprehensive literature search was conducted in the databases PubMed, Scopus, WoS, MedLine, and Cochrane Library up to April 2024. Studies assessing the efficacy of anlotinib combined with whole-brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), or other radiotherapy modalities in NSCLC patients with brain metastasis were included. The primary outcomes were (a) the efficacy of anlotinib and radiotherapy on the intracranial lesions and OS and (b) the effectiveness of combined anlotinib and radiotherapy versus radiotherapy alone in NSCLC patients with brain metastasis. The secondary outcome was the efficacy of anlotinib and radiotherapy on extracranial progression. We used a combination of keywords and MeSH terms including ‘non-small cell lung cancer’ OR ‘NSCLC’, ‘brain metastases’, ‘anlotinib’, ‘radiotherapy’, ‘radiation therapy’, and ‘combined treatment’, among others. Boolean operators (AND, OR) were applied as appropriate to optimize the search strategy across databases. <b>Results</b>: Nine studies met the inclusion criteria, comprising 210 patients in the combination group and 228 patients in the radiotherapy alone group. The combination of anlotinib with radiotherapy showed a significant improvement in iPFS compared to radiotherapy alone, with a pooled risk ratio (RR) for iORR of 1.18 (95% CI: 1.00–1.39) and a pooled SMD for OS of 0.03 (95% CI: −0.29, 0.36). Radiotherapy combined with anlotinib also demonstrated enhanced intracranial and extracranial control rates. <b>Conclusions</b>: Anlotinib combined with radiotherapy, especially WBRT, offers a promising treatment strategy for NSCLC patients with brain metastasis, improving intracranial control. Further large-scale randomized controlled trials are needed to confirm these findings and optimize treatment protocols. |
| format | Article |
| id | doaj-art-6ebb62cf435d41918ea72031f2927ca2 |
| institution | DOAJ |
| issn | 1424-8247 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj-art-6ebb62cf435d41918ea72031f2927ca22025-08-20T02:47:14ZengMDPI AGPharmaceuticals1424-82472025-06-0118797410.3390/ph18070974Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-AnalysisHelal F. Hetta0Mostafa A. Sayed Ali1Saleh F. Alqifari2Hoda A. Salem3Khulood A. Qasem4Fawaz E. Alanazi5Amirah Alhowiti6Amirah M. Alatawi7Hyder Mirghani8Tariq Alrasheed9Salwa Q. Bukhari10Khalid A. Almazyad11Sultan A. Alhumaid12Noura H. Abd Ellah13Hashim M. Aljohani14Yasmin N. Ramadan15Reem Sayad16Division of Microbiology, Immunology and Biotechnology, Department of Natural Products and Alternative Medicine, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi ArabiaDepartment of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi ArabiaDepartment of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi ArabiaDepartment of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi ArabiaCollege of Medicine, Sulaiman Alrajhi University, Al Bukairiyah 52726, Saudi ArabiaDepartment of Pharmacology and Toxicology, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi ArabiaDepartment of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi ArabiaDepartment of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi ArabiaDepartment of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi ArabiaDepartment of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk 71491, Saudi ArabiaDiagnostic Radiology Department, Faculty of Medicine, University of Tabuk, P.O. Box 741, Tabuk 71491, Saudi ArabiaDepartment of Adult Medical Oncology, King Abdulaziz Medical City, Riyadh 14611, Saudi ArabiaDepartment of Family Medicine, King Salman Armed Forces Hospital, Tabuk 47512, Saudi ArabiaDepartment of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Badr University in Assiut, Naser City 2014101, EgyptDepartment of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madina 41477, Saudi ArabiaDepartment of Microbiology and Immunology, Faculty of Pharmacy, Assiut University, Assiut 71515, EgyptDepartment of Histology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt<b>Background/Objectives</b>: Non-small-cell lung cancer (NSCLC) frequently metastasizes to the brain, significantly impacting patient prognosis and quality of life. Anlotinib, a novel tyrosine kinase inhibitor, has shown promise in treating NSCLC with brain metastasis. So, we aimed to evaluate the clinical efficacy of anlotinib and various types of radiotherapy combinations used to treat NSCLC patients with brain metastasis regarding overall survival and the treatment of internal and external lesions. <b>Methods</b>: A comprehensive literature search was conducted in the databases PubMed, Scopus, WoS, MedLine, and Cochrane Library up to April 2024. Studies assessing the efficacy of anlotinib combined with whole-brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), or other radiotherapy modalities in NSCLC patients with brain metastasis were included. The primary outcomes were (a) the efficacy of anlotinib and radiotherapy on the intracranial lesions and OS and (b) the effectiveness of combined anlotinib and radiotherapy versus radiotherapy alone in NSCLC patients with brain metastasis. The secondary outcome was the efficacy of anlotinib and radiotherapy on extracranial progression. We used a combination of keywords and MeSH terms including ‘non-small cell lung cancer’ OR ‘NSCLC’, ‘brain metastases’, ‘anlotinib’, ‘radiotherapy’, ‘radiation therapy’, and ‘combined treatment’, among others. Boolean operators (AND, OR) were applied as appropriate to optimize the search strategy across databases. <b>Results</b>: Nine studies met the inclusion criteria, comprising 210 patients in the combination group and 228 patients in the radiotherapy alone group. The combination of anlotinib with radiotherapy showed a significant improvement in iPFS compared to radiotherapy alone, with a pooled risk ratio (RR) for iORR of 1.18 (95% CI: 1.00–1.39) and a pooled SMD for OS of 0.03 (95% CI: −0.29, 0.36). Radiotherapy combined with anlotinib also demonstrated enhanced intracranial and extracranial control rates. <b>Conclusions</b>: Anlotinib combined with radiotherapy, especially WBRT, offers a promising treatment strategy for NSCLC patients with brain metastasis, improving intracranial control. Further large-scale randomized controlled trials are needed to confirm these findings and optimize treatment protocols.https://www.mdpi.com/1424-8247/18/7/974anlotinibnovel multi-targeting tyrosine kinase inhibitorcombined non-small-cell lung cancerNSCLCbrain metastasisradiotherapy |
| spellingShingle | Helal F. Hetta Mostafa A. Sayed Ali Saleh F. Alqifari Hoda A. Salem Khulood A. Qasem Fawaz E. Alanazi Amirah Alhowiti Amirah M. Alatawi Hyder Mirghani Tariq Alrasheed Salwa Q. Bukhari Khalid A. Almazyad Sultan A. Alhumaid Noura H. Abd Ellah Hashim M. Aljohani Yasmin N. Ramadan Reem Sayad Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-Analysis Pharmaceuticals anlotinib novel multi-targeting tyrosine kinase inhibitor combined non-small-cell lung cancer NSCLC brain metastasis radiotherapy |
| title | Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-Analysis |
| title_full | Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-Analysis |
| title_fullStr | Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-Analysis |
| title_full_unstemmed | Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-Analysis |
| title_short | Is Anlotinib and Radiotherapy Combination Effective for Non-Small-Cell Lung Cancer with Brain Metastases? A Systematic Scoping Review and Meta-Analysis |
| title_sort | is anlotinib and radiotherapy combination effective for non small cell lung cancer with brain metastases a systematic scoping review and meta analysis |
| topic | anlotinib novel multi-targeting tyrosine kinase inhibitor combined non-small-cell lung cancer NSCLC brain metastasis radiotherapy |
| url | https://www.mdpi.com/1424-8247/18/7/974 |
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