Efficacy and safety of EFGR tyrosine kinase inhibitor monotherapy with docetaxel monotherapy in previously treated advanced non-small-cell lung cancer:a Meta-analysis

Yang Yingqing; Jiang Depeng; Jiang Youfan

doi:10.13406/j.cnki.cyxb.000949

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Efficacy and safety of EFGR tyrosine kinase inhibitor monotherapy with docetaxel monotherapy in previously treated advanced non-small-cell lung cancer:a Meta-analysis

更新时间：2024-01-17

- Efficacy and safety of EFGR tyrosine kinase inhibitor monotherapy with docetaxel monotherapy in previously treated advanced non-small-cell lung cancer:a Meta-analysis
- Journal of Chongqing Medical University Vol. 41, Issue 9, Pages: 959-963(2016)
- 作者机构：
  
  重庆医科大学附属第二医院呼吸内科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000949
  CLC： R734.2
- Published：2016，
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[1]杨迎庆,江德鹏,蒋幼凡.EGFR-TKI与多西他赛二线治疗非小细胞肺癌有效性与安全性的Meta分析[J].重庆医科大学学报,2016,41(09):959-963.

Yang Yingqing, Jiang Depeng, Jiang Youfan. Efficacy and safety of EFGR tyrosine kinase inhibitor monotherapy with docetaxel monotherapy in previously treated advanced non-small-cell lung cancer:a Meta-analysis. [J]. Journal of Chongqing Medical University 41(9):959-963(2016)
[1]杨迎庆,江德鹏,蒋幼凡.EGFR-TKI与多西他赛二线治疗非小细胞肺癌有效性与安全性的Meta分析[J].重庆医科大学学报,2016,41(09):959-963. DOI： 10.13406/j.cnki.cyxb.000949.

Yang Yingqing, Jiang Depeng, Jiang Youfan. Efficacy and safety of EFGR tyrosine kinase inhibitor monotherapy with docetaxel monotherapy in previously treated advanced non-small-cell lung cancer:a Meta-analysis. [J]. Journal of Chongqing Medical University 41(9):959-963(2016) DOI： 10.13406/j.cnki.cyxb.000949.

摘要

目的:系统评价单药表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitor

EGFR-TKI）（包括吉非替尼和厄洛替尼）与单药多西他赛二线治疗晚期非小细胞肺癌的疗效和安全性。方法:检索PUBMED、Embase、Cochrane Library、CNKI、万方、维普等数据库

收集1995年1月

015年3月期间有关表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitor

EGFR-TKI）对比多西他赛二线治疗晚期非小细胞肺癌的临床随机对照试验（RTC）

2名独立研究员根据纳入与排除标准筛选文献

进行文献质量评价

计算风险比（hazard ratio

HR）、相对危险度（relative risk

RR）值及其95%可信区间（confidence interval

CI）

所有数据均采用Review Manager 5.3.0软件进行统计学分析。结果:纳入6篇临床随机对照试验（RTC）

病例数总计2 747例

其中EGFR-TKI治疗组1 389例

多西他赛治疗组1 358例。Meta分析结果显示EGFR-TKI与多西他赛相比总生存期差异（HR=1.05

95%CI=0.96

.14

Z=0.97

P=0.33）无显著统计学意义。多西他赛组相较于厄洛替尼组可延长患者无进展生存期（HR=1.31

95%CI=1.11

.54

Z=3.24

P=0.001）

但多西他赛组与吉非替尼组患者无进展生存期并无显著差异（HR=0.90

95%CI=0.78

.04

Z=1.40

P=0.16）。在安全性分析方面

EGFR-TKI组3

级不良反应的发生率较低

如中性粒细胞减少症（RR=0.06

95%CI=0.04

.08）、发热性中性粒细胞减少（RR=0.09

95%CI=0.05

.16）、神经毒性（RR=0.25

95%CI=0.05

.16）等

但3

级皮疹（RR=15.03

95%CI=5.81

8.88）的发生率有所增加。结论:EGFR-TKI对比多西他赛二线治疗非小细胞肺癌在总生存、无进展生存期上并无统计学差异

但EGFR-TKI不良反应发生率更低

耐受性较好。

Abstract

Objective:To systematically evaluate the efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitor monotherapy(gefitinib or erlotinib)with docetaxel monotherapy in previously treated advanced non-small-cell lung cancer(NSCLC).Methods:Pub Med

Embase

Cochrane library

CNKI

Wan-fang Data and VIP were searched to collect randomized clinical trials(RCTs)comparing EGFR-TKI monotherapy with docetaxel chemotherapy in previously treated advanced NSCLC. The hazard ratio(HR)or odds ratio(OR)

with their corresponding 95% confidence intervals(CI)were pooled using Review manager 5.3.0. Results:Six randomized controlled trials involving 2747patients(EGFR-TKI 1389 patients

docetaxel 1358 patients)were eligible. The pooled HRs showed no significant difference in OS(HR=0.90

95%CI=0.78 to 1.04

Z=1.40

P=0.16). PFS was elongated in docetaxel group than in erlotinib group(HR=1.31

95%CI=1.11 to 1.54

Z=3.24

P=0.001). There was no difference in PFS between docetaxel group and gentitinib group(HR=0.90

95%CI=0.78 to 1.04

Z=1.40

P=0.16). Safety analysis showed that incidence of side effect at grade 3 or 4 was low in EGFR-TKI group;the side effects included neutropeni(RR=0.06

95%CI=0.04 to 0.08)

febrile

neutropenia(RR =0.09

95% CI =0.05 to 0.16)

and nurotoxicity(RR=0.25

995%CI=0.05 to 0.16). The incidence of rash at grade3 or 4 was increased(RR=15.03

95%CI=5.81 to 38.88). Conclusion:Although having similar OS and PFS

EGFR-TKI is safer and better tolerated.

关键词

吉非替尼厄洛替尼多西他赛非小细胞肺癌二线治疗Meta分析

Keywords

gefitiniberlotinibdocetaxelnon-small cell lung cancersecond-line therapyMeta-analysis

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