Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis
Several randomized controlled trials (RCTs) evaluated the afatinib efficacy in patients with advanced non-small cell lung cancer (NSCLC) and recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). This review systemically outlined and meta-analyzed the afatinib efficacy in NSCLC and...
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MDPI AG
2021-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/4/688 |
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| author | Nian N. N. Maarof Abdulsamad Alsalahi Emilia Abdulmalek Sharida Fakurazi Bimo Ario Tejo Mohd Basyaruddin Abdul Rahman |
| author_facet | Nian N. N. Maarof Abdulsamad Alsalahi Emilia Abdulmalek Sharida Fakurazi Bimo Ario Tejo Mohd Basyaruddin Abdul Rahman |
| author_sort | Nian N. N. Maarof |
| collection | DOAJ |
| description | Several randomized controlled trials (RCTs) evaluated the afatinib efficacy in patients with advanced non-small cell lung cancer (NSCLC) and recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). This review systemically outlined and meta-analyzed the afatinib efficacy in NSCLC and R/M HNSCC in terms of overall survival (OS) and progression-free survival (PFS) endpoints. Records were retrieved from PubMed, Web of Science, and ScienceDirect from 2011 to 2020. Eight afatinib RCTs were included and assessed for the risk of bias. In meta-analysis, overall pooled effect size (ES) of OS in afatinib group (AG) significantly improved in all RCTs and NSCLC-RCTs [hazard ratios (HRs): 0.89 (95% CI: 0.81–0.98, <i>p</i> = 0.02); I<sup>2</sup> = 0%, <i>p</i> = 0.71/ 0.86 (95% CI: 0.76–0.97; <i>p</i> = 0.02); I<sup>2</sup> = 0%, <i>p</i> = 0.50, respectively]. ES of PFS in AG significantly improved in all RCTs, NSCLC-RCTs, and HNSCC-RCTs [HRs: 0.75 (95% CI: 0.68–0.83; <i>p</i> < 0.00001); I<sup>2</sup> = 26%, <i>p</i> = 0.24; 0.75 (95% CI: 0.66–0.84; <i>p</i> < 0.00001); I<sup>2</sup> = 47%, <i>p</i> = 0.15/0.76 (95% CI: 0.65–88; <i>p</i> = 0.0004); I<sup>2</sup> = 34%, <i>p</i> = 0.0004, respectively]. From a clinical viewpoint of severity, interstitial lung disease, dyspnea, pneumonia, acute renal failure, and renal injury were rarely incident adverse events in the afatinib group. In conclusion, first- and second-line afatinib monotherapy improved the survival of patients with NSCLC, while second-line afatinib monotherapy could be promising for R/M HNSCC. The prospective protocol is in PROSPERO (ID = CRD42020204547). |
| first_indexed | 2024-03-09T05:04:42Z |
| format | Article |
| id | doaj.art-11cd8494c9ec44a897db56293f40bab8 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T05:04:42Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-11cd8494c9ec44a897db56293f40bab82023-12-03T12:55:23ZengMDPI AGCancers2072-66942021-02-0113468810.3390/cancers13040688Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-AnalysisNian N. N. Maarof0Abdulsamad Alsalahi1Emilia Abdulmalek2Sharida Fakurazi3Bimo Ario Tejo4Mohd Basyaruddin Abdul Rahman5Integrated Chemical BioPhysics Research, Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Selangor, MalaysiaDepartment of Pharmacology, Faculty of Pharmacy, Sana’a University, Mazbah District, Sana’a Secretariat 1247, YemenIntegrated Chemical BioPhysics Research, Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Selangor, MalaysiaLaboratory of Vaccines and Immunotherapeutics, Institute of Bioscience, Universiti Putra Malaysia UPM, Serdang 43400, Selangor, MalaysiaIntegrated Chemical BioPhysics Research, Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Selangor, MalaysiaIntegrated Chemical BioPhysics Research, Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Selangor, MalaysiaSeveral randomized controlled trials (RCTs) evaluated the afatinib efficacy in patients with advanced non-small cell lung cancer (NSCLC) and recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). This review systemically outlined and meta-analyzed the afatinib efficacy in NSCLC and R/M HNSCC in terms of overall survival (OS) and progression-free survival (PFS) endpoints. Records were retrieved from PubMed, Web of Science, and ScienceDirect from 2011 to 2020. Eight afatinib RCTs were included and assessed for the risk of bias. In meta-analysis, overall pooled effect size (ES) of OS in afatinib group (AG) significantly improved in all RCTs and NSCLC-RCTs [hazard ratios (HRs): 0.89 (95% CI: 0.81–0.98, <i>p</i> = 0.02); I<sup>2</sup> = 0%, <i>p</i> = 0.71/ 0.86 (95% CI: 0.76–0.97; <i>p</i> = 0.02); I<sup>2</sup> = 0%, <i>p</i> = 0.50, respectively]. ES of PFS in AG significantly improved in all RCTs, NSCLC-RCTs, and HNSCC-RCTs [HRs: 0.75 (95% CI: 0.68–0.83; <i>p</i> < 0.00001); I<sup>2</sup> = 26%, <i>p</i> = 0.24; 0.75 (95% CI: 0.66–0.84; <i>p</i> < 0.00001); I<sup>2</sup> = 47%, <i>p</i> = 0.15/0.76 (95% CI: 0.65–88; <i>p</i> = 0.0004); I<sup>2</sup> = 34%, <i>p</i> = 0.0004, respectively]. From a clinical viewpoint of severity, interstitial lung disease, dyspnea, pneumonia, acute renal failure, and renal injury were rarely incident adverse events in the afatinib group. In conclusion, first- and second-line afatinib monotherapy improved the survival of patients with NSCLC, while second-line afatinib monotherapy could be promising for R/M HNSCC. The prospective protocol is in PROSPERO (ID = CRD42020204547).https://www.mdpi.com/2072-6694/13/4/688afatinibrandomized clinical trialsnon-small cell lung cancerhead and neck squamous cell carcinoma |
| spellingShingle | Nian N. N. Maarof Abdulsamad Alsalahi Emilia Abdulmalek Sharida Fakurazi Bimo Ario Tejo Mohd Basyaruddin Abdul Rahman Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis Cancers afatinib randomized clinical trials non-small cell lung cancer head and neck squamous cell carcinoma |
| title | Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis |
| title_full | Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis |
| title_fullStr | Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis |
| title_short | Efficacy of Afatinib in the Treatment of Patients with Non-Small Cell Lung Cancer and Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis |
| title_sort | efficacy of afatinib in the treatment of patients with non small cell lung cancer and head and neck squamous cell carcinoma a systematic review and meta analysis |
| topic | afatinib randomized clinical trials non-small cell lung cancer head and neck squamous cell carcinoma |
| url | https://www.mdpi.com/2072-6694/13/4/688 |
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