Effectiveness of EGFR-TKIs versus Chemotherapy as First-line Treatment for Advanced Non-small Cell Lung Cancer：A Meta-analysis
10.3779/j.issn.1009-3419.2015.03.04
- VernacularTitle:EGFR-TKIs与化疗比较一线治疗非小细胞肺癌疗效的meta分析
- Author:
CAO FEIFEI
1
;
ZHANG LINLIN
;
WANG SHUANG
;
ZHONG DIANSHENG
;
WANG YAN
Author Information
1. 天津医科大学总医院呼吸内科
- Keywords:
EGFR-TKIs;
Lung neoplasms;
Chemotherapy;
First-line treatment;
Meta-analysis
- From:
Chinese Journal of Lung Cancer
2015;(3):146-154
- CountryChina
- Language:Chinese
-
Abstract:
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 eects. However, some patients fail to benefit from this treatment. e 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 chemo-therapy. Our results could be used as basis to guide clinical therapy. Methods Randomized controlled trials evaluating the ef-ficacy 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 Biol-ogy 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 chemo-therapy 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 dierence was observed in overall survival (OS; HR=0.99; 95%CI: 0.84-1.16). e 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 dier. Likewise, the PFS and the OS of the unselected patients in the EGFR-TKI treatment group and the chemotherapy group did not significantly dier, although the OS of the former was shorter than that of the laer. Con-clusion 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.
