Cargando…

化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析

BACKGROUND AND OBJECTIVE: The combination therapy of chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has attracted the attention of more and more investigators. The aim of this meta-analysis is to evaluate the clinical efficacy and safety of intercalated comb...

Descripción completa

Detalles Bibliográficos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 中国肺癌杂志编辑部 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973456/
https://www.ncbi.nlm.nih.gov/pubmed/27978869
http://dx.doi.org/10.3779/j.issn.1009-3419.2016.12.06
_version_ 1783326638463778816
collection PubMed
description BACKGROUND AND OBJECTIVE: The combination therapy of chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has attracted the attention of more and more investigators. The aim of this meta-analysis is to evaluate the clinical efficacy and safety of intercalated combination of chemotherapy and EGFR-TKIs versus chemotherapy alone in the first-line therapy of advanced non-small cell lung cancer (NSCLC). METHODS: We retrieved the Cochrane Library, PubMed, EMBASE, CBM, CNKI and Wanfang databases for randomized controlled trials which involved the intercalated combination of chemotherapy and EGFR-TKIs, and chemotherapy alone in the first-line treatment of advanced NSCLC. The progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events were analyzed. The quality evaluation and cross-checked data were independently performed by two investigators according to the Cochrane Systematic Reviews Handbook. The Stata 12.0 software was used to conduct the meta-analysis. RESULTS: This study included 933 NSCLC patients from 6 RCTs. The meta-analysis demonstrated that the intercalated combination of chemotherapy and EGFR-TKIs significantly prolonged the PFS (HR=0.72, 95%CI: 0.53-0.98, P=0.037) of advanced NSCLC patients compared with mono-chemotherapy. However, there was no statistical difference in OS (HR=0.85, 95%CI: 0.72-1.01, P=0.060), ORR (OR=1.59, 95%CI: 0.86-2.95, P=0.142) and DCR (OR=1.09, 95%CI: 0.95-1.25, P=0.226) between the two groups. Further, the subgroup analysis showed that the intercalated combination markedly improved the PFS in female, adenocarcinoma, never smoking, EGFR mutant patients. In the aspect of safety, the main side effects of the intercalated combination therapy were rash (OR=7.81, 95%CI: 3.74-16.34, P < 0.001) and diarrhea (OR=2.73, 95%CI: 1.92-3.89, P < 0.001). CONCLUSIONS: The intercalated combination of chemotherapy and EGFR-TKIs significantly prolonged the PFS in the first-line therapy of advanced NSCLC patients compared with mono-chemotherapy, and the main adverse events were tolerable rash and diarrhea. Together, the intercalated combination shows promising results, and more large-scale and high-quality RCTs are still needed.
format Online
Article
Text
id pubmed-5973456
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher 中国肺癌杂志编辑部
record_format MEDLINE/PubMed
spelling pubmed-59734562018-07-06 化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析 Zhongguo Fei Ai Za Zhi 临床研究 BACKGROUND AND OBJECTIVE: The combination therapy of chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has attracted the attention of more and more investigators. The aim of this meta-analysis is to evaluate the clinical efficacy and safety of intercalated combination of chemotherapy and EGFR-TKIs versus chemotherapy alone in the first-line therapy of advanced non-small cell lung cancer (NSCLC). METHODS: We retrieved the Cochrane Library, PubMed, EMBASE, CBM, CNKI and Wanfang databases for randomized controlled trials which involved the intercalated combination of chemotherapy and EGFR-TKIs, and chemotherapy alone in the first-line treatment of advanced NSCLC. The progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events were analyzed. The quality evaluation and cross-checked data were independently performed by two investigators according to the Cochrane Systematic Reviews Handbook. The Stata 12.0 software was used to conduct the meta-analysis. RESULTS: This study included 933 NSCLC patients from 6 RCTs. The meta-analysis demonstrated that the intercalated combination of chemotherapy and EGFR-TKIs significantly prolonged the PFS (HR=0.72, 95%CI: 0.53-0.98, P=0.037) of advanced NSCLC patients compared with mono-chemotherapy. However, there was no statistical difference in OS (HR=0.85, 95%CI: 0.72-1.01, P=0.060), ORR (OR=1.59, 95%CI: 0.86-2.95, P=0.142) and DCR (OR=1.09, 95%CI: 0.95-1.25, P=0.226) between the two groups. Further, the subgroup analysis showed that the intercalated combination markedly improved the PFS in female, adenocarcinoma, never smoking, EGFR mutant patients. In the aspect of safety, the main side effects of the intercalated combination therapy were rash (OR=7.81, 95%CI: 3.74-16.34, P < 0.001) and diarrhea (OR=2.73, 95%CI: 1.92-3.89, P < 0.001). CONCLUSIONS: The intercalated combination of chemotherapy and EGFR-TKIs significantly prolonged the PFS in the first-line therapy of advanced NSCLC patients compared with mono-chemotherapy, and the main adverse events were tolerable rash and diarrhea. Together, the intercalated combination shows promising results, and more large-scale and high-quality RCTs are still needed. 中国肺癌杂志编辑部 2016-12-20 /pmc/articles/PMC5973456/ /pubmed/27978869 http://dx.doi.org/10.3779/j.issn.1009-3419.2016.12.06 Text en 版权所有©《中国肺癌杂志》编辑部2016 https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) License. See: https://creativecommons.org/licenses/by/3.0/
spellingShingle 临床研究
化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
title 化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
title_full 化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
title_fullStr 化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
title_full_unstemmed 化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
title_short 化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
title_sort 化疗间插联合egfr-tkis对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
topic 临床研究
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973456/
https://www.ncbi.nlm.nih.gov/pubmed/27978869
http://dx.doi.org/10.3779/j.issn.1009-3419.2016.12.06
work_keys_str_mv AT huàliáojiānchāliánhéegfrtkisduìbǐdāndúhuàliáoyīxiànzhìliáowǎnqīfēixiǎoxìbāofèiáidemetafēnxī
AT huàliáojiānchāliánhéegfrtkisduìbǐdāndúhuàliáoyīxiànzhìliáowǎnqīfēixiǎoxìbāofèiáidemetafēnxī
AT huàliáojiānchāliánhéegfrtkisduìbǐdāndúhuàliáoyīxiànzhìliáowǎnqīfēixiǎoxìbāofèiáidemetafēnxī