Comparative efficacy and safety of first-line EGFR-TKIs for advanced non-small cell lung cancer：a network meta-analysis
10.16462/j.cnki.zhjbkz.2020.02.017
- Author:
Hui-fang ZHANG
1
;
Jin-sha MA
;
Lu LI
;
Qian GAO
;
Tong WANG
Author Information
1. Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
- Publication Type:Research Article
- Keywords:
Non-small cell lung cancer;
Gefitinib;
Erlotinib;
Afatinib;
First-line treatment;
Network meta-analysis
- From:
Chinese Journal of Disease Control & Prevention
2020;24(2):210-216
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of gefitinib, erlotinib, and afatinib in the first-line treatment of advanced non-small cell lung cancer (NSCLC). Methods PubMed, EMBASE, and The Cochrane Library were searched to identify the relevant literatures published from December 2008 to December 2018. Bayesian network meta-analysis was carried out to rank the three treatments. Results A total of ten eligible studies involving 2275 patients were enrolled. In terms of efficacy, the surface under the cumulative ranking (SUCRA) indicated that erlotinib performed best in progression-free survival(PFS)(0.88), afatinib performed best in objective response rate(ORR)(0.82) and disease control rate(DCR) (0.86), gefitinib performed worst in PFS (0.45), ORR(0.42), and DCR(0.45). For safety, the differences of grade 3 or 4 adverse events rate (OR=0.29,95%CI:0.08-0.98) and discontinuation rate(OR=0.14,95%CI:0.01-0.8) between erlotinib and the platinum-based doublet chemotherapy were statistically significant. The ranking results also supported that erlotinib was the safest. SUCRA results suggested that gefitinib (0.31) had a lower grade 3 or 4 adverse events rate than afatinib (0.57), and the possibility of discontinuation in gefitinib (0.44) was similar to that of afatinib (0.41). Conclusion Erlotinib might be the preferred first-line treatment for advanced NSCLC after weighing and balancing the benefits and risks.
