Meta-analysis of occurrence of interstitial lung disease in patients with non-small cell lung cancer treated with epidermal growth factor receptor tyrosine kinase inhibitors
10.3760/cma.j.cn114015-20220602-00489
- VernacularTitle:非小细胞肺癌患者EGFR-TKI相关间质性肺疾病发生情况的meta分析
- Author:
Shanshan LI
1
;
Xiaohan XU
1
;
Ziyang WU
1
;
Suodi ZHAI
1
;
Jian WEN
1
;
Yinchu CHENG
1
Author Information
1. 北京大学第三医院药剂科，北京 100191
- Publication Type:Journal Article
- Keywords:
Receptor, epidermal growth factor;
Tyrosine;
Enzyme inhibitors;
Carcinoma, non-small-cell lung;
Lung diseases, interstitial;
Meta-analysis
- From:
Adverse Drug Reactions Journal
2022;24(12):624-632
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the occurrence of interstitial lung disease (ILD) in patients with non-small cell lung cancer (NSCLC) treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI).Methods:PubMed, Embase, The Cochrane Library, CNKI, WanFang, and VIP databases were searched up to April 30, 2022. Randomized controlled trials (RCT) about NSCLC treated with EGFR-TKI (8 kinds listed in China, including gefitinib, erlotinib, icotinib, afatinib, dacomitinib, osimertinib, almonertinib, and furmonertinib) compared with chemotherapy were collected. Patients was treated with EGFR-TKI monotherapy in the trial group and chemotherapy in the control group. The outcomes included the occurrence of ILD. RevMan 5.4 software was used for meta-analysis, and the effect sizes were odds ratio ( OR) and the 95% confidence interval ( CI). Results:A total of 15 RCT were entered in the analysis, including 6 about gefitinib, 5 about erlotinib, 2 about icotinib, and 2 about afatinib, involving 2 318 patients in the trial group and 1 975 in the control group. Meta-analysis showed that the overall incidence of ILD in the trial group were higher than that in the control group [1.47% (34/2 318) vs. 0.51% (10/1 975), OR=2.44, P=0.004]; difference in incidences of ILD-related death between the 2 groups was not significant [0.35% (8/2 318) vs. 0.05% (1/1 975), OR=3.29, P=0.07]. The severity of ILD was graded in 14 RCT, and the meta-analysis showed that the incidence of more than grade 3 ILD in the trial group was higher than that in the control group [0.62%(13/2 089) vs. 0.11% (2/1 864), OR=2.60, P=0.04]. The overall incidences of ILD and the incidences of more than grade 3 ILD in the gefitinib group were higher than those in the corresponding control groups [2.31%(27/1 167) vs. 0.71% (8/1 123), OR=2.88, P=0.004; 0.86% (7/1 167) vs. 0.09% (1/1 123), OR=3.98, P=0.03]. There was no significant difference in ILD occurrence between the trial group and the control group for afatinib and erlotinib (all P>0.05). No ILD occurred in the trail group or in the control group in RCT about icotinib. Conclusions:Compared with chemotherapy, NSCLC patients receiving EGFR-TKI, especially gefitinib, have higher risks of ILD and serious ILD. Therefore, clinical vigilance and monitoring should be strengthened.
