Curative Effect of EGFR-TKIs with Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant Non-small Cell Lung Cancer：a Meta-analysis
BackgroundAcquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) will eventually occur in almost all advanced EGFR-mutant non-small cell lung cancer (EGFR-mutant NSCLC) patients although the therapy has been a standard treatment for such patients. But EGFR-TKI...
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| Natura: | Articolo |
| Lingua: | zho |
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Chinese General Practice Publishing House Co., Ltd
2022-03-01
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| Serie: | Zhongguo quanke yixue |
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| Accesso online: | https://www.chinagp.net/fileup/1007-9572/PDF/yx2021123102.pdf |
| _version_ | 1827289871744499712 |
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| author | LI Yong, LONG Yong, ZHAO Chong, ZHANG Guanqing, SU Yanhe |
| author_facet | LI Yong, LONG Yong, ZHAO Chong, ZHANG Guanqing, SU Yanhe |
| author_sort | LI Yong, LONG Yong, ZHAO Chong, ZHANG Guanqing, SU Yanhe |
| collection | DOAJ |
| description | BackgroundAcquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) will eventually occur in almost all advanced EGFR-mutant non-small cell lung cancer (EGFR-mutant NSCLC) patients although the therapy has been a standard treatment for such patients. But EGFR-TKIs in combination with anti-angiogenic drugsmay prolong the survival time of these patients.ObjectiveTo explore the efficacy and safety of EGFR-TKIs with anti-angiogenic drugs as the treatment for patients with advanced EGFR-mutant NSCLC.MethodsDatabases including CNKI, CQVIP, Wanfang Data Knowledge Service Platform, PubMed, EMBase, and The Cochrane Library were searched from inception to July 2021 using subject headings with free-text words, for randomized controlled trials (RCTs) about the first-line treatment of advanced EGFR-mutant NSCLC patients with EGFR-TKIs in combination with anti-angiogenic drugs (combination therapy group) versus EGFR-TKIs alone (monotherapy group) . Two researchers performed literature screening, data extraction (the first author, publication time, the country where the author coming from, study type, sample size, stage of NSCLC, sex, average age, treatment regimen, ECOG PS score, median follow-up time, pathological type, gene mutation type, outcome indicators) , separately, and assessed risk of bias in the included RCTs. STATA 15.0 was used formeta-analysis.ResultsNine RCTs were included, involving 1 553 patients. Meta-analysis results showed that the combination therapy was associated with longer progression-free survival (PFS) 〔HR=0.61, 95%CI (0.54, 0.70) , P<0.001〕. Further analysis based on PFS revealed that the combination therapy did not significantly prolong the PFS in those aged ≥65 yearsand in those with brain metastases (P>0.05) . Moreover, the combination therapy was not superior to monotherapy in terms of prolonging the overall survival, and improving the objective response rate, and disease control rate (P>0.05) . However, the rate of adverse eventsabove grade 3〔RR=1.77, 95%CI (1.62, 1.94) , P<0.001〕was significantly increased.ConclusionBy using the combination therapy, advanced EGFR-mutant NSCLC patients may obtain a prolonged PFS, but with increased risk of serious adverse events. In addition, the patients could not obtain a prolonged overall survival, higher objective response rate and disease control rate. |
| first_indexed | 2024-04-24T11:58:27Z |
| format | Article |
| id | doaj.art-356df64412ea4d2c890ad0e8e4c71fba |
| institution | Directory Open Access Journal |
| issn | 1007-9572 |
| language | zho |
| last_indexed | 2024-04-24T11:58:27Z |
| publishDate | 2022-03-01 |
| publisher | Chinese General Practice Publishing House Co., Ltd |
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| series | Zhongguo quanke yixue |
| spelling | doaj.art-356df64412ea4d2c890ad0e8e4c71fba2024-04-09T02:51:59ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722022-03-0125081007101310.12114/j.issn.1007-9572.2021.01.413Curative Effect of EGFR-TKIs with Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant Non-small Cell Lung Cancer：a Meta-analysisLI Yong, LONG Yong, ZHAO Chong, ZHANG Guanqing, SU Yanhe0 Department of Thoracic Surgery，Second Affiliated Hospital of Zhengzhou University，Zhengzhou 450000，China * Corresponding author：SU Yanhe，Professor，Chief physician；E-mail：syh1971@sina.com BackgroundAcquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) will eventually occur in almost all advanced EGFR-mutant non-small cell lung cancer (EGFR-mutant NSCLC) patients although the therapy has been a standard treatment for such patients. But EGFR-TKIs in combination with anti-angiogenic drugsmay prolong the survival time of these patients.ObjectiveTo explore the efficacy and safety of EGFR-TKIs with anti-angiogenic drugs as the treatment for patients with advanced EGFR-mutant NSCLC.MethodsDatabases including CNKI, CQVIP, Wanfang Data Knowledge Service Platform, PubMed, EMBase, and The Cochrane Library were searched from inception to July 2021 using subject headings with free-text words, for randomized controlled trials (RCTs) about the first-line treatment of advanced EGFR-mutant NSCLC patients with EGFR-TKIs in combination with anti-angiogenic drugs (combination therapy group) versus EGFR-TKIs alone (monotherapy group) . Two researchers performed literature screening, data extraction (the first author, publication time, the country where the author coming from, study type, sample size, stage of NSCLC, sex, average age, treatment regimen, ECOG PS score, median follow-up time, pathological type, gene mutation type, outcome indicators) , separately, and assessed risk of bias in the included RCTs. STATA 15.0 was used formeta-analysis.ResultsNine RCTs were included, involving 1 553 patients. Meta-analysis results showed that the combination therapy was associated with longer progression-free survival (PFS) 〔HR=0.61, 95%CI (0.54, 0.70) , P<0.001〕. Further analysis based on PFS revealed that the combination therapy did not significantly prolong the PFS in those aged ≥65 yearsand in those with brain metastases (P>0.05) . Moreover, the combination therapy was not superior to monotherapy in terms of prolonging the overall survival, and improving the objective response rate, and disease control rate (P>0.05) . However, the rate of adverse eventsabove grade 3〔RR=1.77, 95%CI (1.62, 1.94) , P<0.001〕was significantly increased.ConclusionBy using the combination therapy, advanced EGFR-mutant NSCLC patients may obtain a prolonged PFS, but with increased risk of serious adverse events. In addition, the patients could not obtain a prolonged overall survival, higher objective response rate and disease control rate.https://www.chinagp.net/fileup/1007-9572/PDF/yx2021123102.pdf|carcinoma, non-small-cell lung|angiogenesis inhibitors|epidermal growth factor receptor tyrosine kinase inhibitors|efficacy|meta-analysis |
| spellingShingle | LI Yong, LONG Yong, ZHAO Chong, ZHANG Guanqing, SU Yanhe Curative Effect of EGFR-TKIs with Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant Non-small Cell Lung Cancer：a Meta-analysis Zhongguo quanke yixue |carcinoma, non-small-cell lung|angiogenesis inhibitors|epidermal growth factor receptor tyrosine kinase inhibitors|efficacy|meta-analysis |
| title | Curative Effect of EGFR-TKIs with
Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant
Non-small Cell Lung Cancer：a Meta-analysis |
| title_full | Curative Effect of EGFR-TKIs with
Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant
Non-small Cell Lung Cancer：a Meta-analysis |
| title_fullStr | Curative Effect of EGFR-TKIs with
Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant
Non-small Cell Lung Cancer：a Meta-analysis |
| title_full_unstemmed | Curative Effect of EGFR-TKIs with
Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant
Non-small Cell Lung Cancer：a Meta-analysis |
| title_short | Curative Effect of EGFR-TKIs with
Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant
Non-small Cell Lung Cancer：a Meta-analysis |
| title_sort | curative effect of egfr tkis with anti angiogenic drugs as the treatment for patients with advanced egfr mutant non small cell lung cancer a meta analysis |
| topic | |carcinoma, non-small-cell lung|angiogenesis inhibitors|epidermal growth factor receptor tyrosine kinase inhibitors|efficacy|meta-analysis |
| url | https://www.chinagp.net/fileup/1007-9572/PDF/yx2021123102.pdf |
| work_keys_str_mv | AT liyonglongyongzhaochongzhangguanqingsuyanhe curativeeffectofegfrtkiswithantiangiogenicdrugsasthetreatmentforpatientswithadvancedegfrmutantnonsmallcelllungcancerametaanalysis |