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EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析

BACKGROUND AND OBJECTIVE: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) has been used for the first-line treatment of non-small cell lung cancer (NSCLC) and has shown good clinical effects. However, some patients fail to benefit from this treatment. The aim of this study is t...

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Formato: Online Artículo Texto
Lenguaje:English
Publicado: 中国肺癌杂志编辑部 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000008/
https://www.ncbi.nlm.nih.gov/pubmed/25800570
http://dx.doi.org/10.3779/j.issn.1009-3419.2015.03.04
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description BACKGROUND AND OBJECTIVE: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) has been used for the first-line treatment of non-small cell lung cancer (NSCLC) and has shown good clinical effects. However, some patients fail to benefit from this treatment. The aim of this study is to analyze whether or not clinical-selected patients (Asian, adenocarcinoma histology, non-smoking) and EGFR mutation-selected patients benefit from EGFR-TKIs or chemotherapy. Our results could be used as basis to guide clinical therapy. METHODS: Randomized controlled trials evaluating the efficacy of EGFR-TKIs versus chemotherapy as first-line treatments of NSCLC were obtained from electronic databases, namely, PubMed, Embase, American Society of Clinical Oncology (ASCO), European Society for Medical Oncology, and China Biology Medicine disc. Assessment, data collection, and statistical analysis were performed according to Cochrane Handbook 5.1.0. RESULTS: A total of 14 randomized controlled trials with 5, 000 patients were included in this study. Compared with the chemotherapy group, EGFR-TKI therapy group in EGFR mutation-selected NSCLC patients showed a higher response rate (RR=2.31; 95%CI: 1.88-2.84) and more significant improvement in progression free survival (PFS; HR=0.39; 95%CI: 0.30-0.49); by contrast, no significant difference was observed in overall survival (OS; HR=0.99; 95%CI: 0.84-1.16). The response rate of clinical-selected patients treated with EGFR-TKI significantly increased (RR=1.30; 95%CI: 1.15-1.47) compared with that of the patients treated with chemotherapy; PFS (HR=0.93; 95%CI: 0.58-1.49) and OS (HR=0.91; 95%CI: 0.81-1.02) of the two groups did not significantly differ. Likewise, the PFS and the OS of the unselected patients in the EGFR-TKI treatment group and the chemotherapy group did not significantly differ, although the OS of the former was shorter than that of the latter. CONCLUSION: EGFR mutation-selected patients received more benefits from EGFR-TKI first-line treatment than other treatments. First-line EGFR-TKI treatment was recommended for clinically selected patients who were unsuitable for themotherapy. By comparison, first-line EGFR-TKI treatment was not a suitable choice for unselected patients.
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spelling pubmed-60000082018-07-06 EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析 Zhongguo Fei Ai Za Zhi 临床研究 BACKGROUND AND OBJECTIVE: Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) has been used for the first-line treatment of non-small cell lung cancer (NSCLC) and has shown good clinical effects. However, some patients fail to benefit from this treatment. The aim of this study is to analyze whether or not clinical-selected patients (Asian, adenocarcinoma histology, non-smoking) and EGFR mutation-selected patients benefit from EGFR-TKIs or chemotherapy. Our results could be used as basis to guide clinical therapy. METHODS: Randomized controlled trials evaluating the efficacy of EGFR-TKIs versus chemotherapy as first-line treatments of NSCLC were obtained from electronic databases, namely, PubMed, Embase, American Society of Clinical Oncology (ASCO), European Society for Medical Oncology, and China Biology Medicine disc. Assessment, data collection, and statistical analysis were performed according to Cochrane Handbook 5.1.0. RESULTS: A total of 14 randomized controlled trials with 5, 000 patients were included in this study. Compared with the chemotherapy group, EGFR-TKI therapy group in EGFR mutation-selected NSCLC patients showed a higher response rate (RR=2.31; 95%CI: 1.88-2.84) and more significant improvement in progression free survival (PFS; HR=0.39; 95%CI: 0.30-0.49); by contrast, no significant difference was observed in overall survival (OS; HR=0.99; 95%CI: 0.84-1.16). The response rate of clinical-selected patients treated with EGFR-TKI significantly increased (RR=1.30; 95%CI: 1.15-1.47) compared with that of the patients treated with chemotherapy; PFS (HR=0.93; 95%CI: 0.58-1.49) and OS (HR=0.91; 95%CI: 0.81-1.02) of the two groups did not significantly differ. Likewise, the PFS and the OS of the unselected patients in the EGFR-TKI treatment group and the chemotherapy group did not significantly differ, although the OS of the former was shorter than that of the latter. CONCLUSION: EGFR mutation-selected patients received more benefits from EGFR-TKI first-line treatment than other treatments. First-line EGFR-TKI treatment was recommended for clinically selected patients who were unsuitable for themotherapy. By comparison, first-line EGFR-TKI treatment was not a suitable choice for unselected patients. 中国肺癌杂志编辑部 2015-03-20 /pmc/articles/PMC6000008/ /pubmed/25800570 http://dx.doi.org/10.3779/j.issn.1009-3419.2015.03.04 Text en 版权所有©《中国肺癌杂志》编辑部2015 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
EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析
title EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析
title_full EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析
title_fullStr EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析
title_full_unstemmed EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析
title_short EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析
title_sort egfr-tkis与化疗比较一线治疗非小细胞肺癌疗效的meta分析
topic 临床研究
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000008/
https://www.ncbi.nlm.nih.gov/pubmed/25800570
http://dx.doi.org/10.3779/j.issn.1009-3419.2015.03.04
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