Immunoregulation of KangAi injection combined with chemotherapy in advanced non-small cell lung cancer: a systematic review and meta-analysis

Objective: To evaluate the immunoregulation of KangAi (KA) injection combined with chemo-treatment (chemo) for Non-small cell lung cancer (NSCLC). Methods: We systematically searched the literature of PubMed, EMBASE, CENTRAL, MEDLINE, CNKI, Wanfang, and VIP databases for all Randomized controlled trials (published from the earliest possible year to January 2019, no language restrictions) comparing KA injection combined with chemo and chemo alone in patients with NSCLC. Our main endpoints were immune function, clinical efficiency, KPS score and adverse events. The Cochrane Risk of Bias tool was applied for quality assessment. Results: 11 studies involving 1060 participants were included. The immune function (MD=3.18, 95% CI: 0.98-4.00, P<0.00001), clinical response rate (RR=1.28, 95%CI: 1.17-1.40, P<0.00001), KPS score (RR=1.86, 95%CI: 1.35-2.57, P=0.0002), and adverse events (RR=0.57, 95%CI: 0.50-0.65, P<0.00001) in the group of KA injection plus Chemo were vastly different from those in Chemo alone. Conclusion: KA injection combined with Chemo in the treatment of NSCLC improved the immune function, clinical efficiency and safety compared to Chemo alone. However, because many of the methodologies included in randomized controlled trials are of poor quality, more rigorous design and large randomized controlled trials are needed to test this benefit.