Meta-analysis of seven randomized control trials to assess the efficacy and toxicity of combining EGFR-TKI with chemotherapy for patients with advanced NSCLC who failed first-line treatment.

摘要: Background: Some recent clinical trials have been conducted to evaluate a combination of EGFR- TKI with chemotherapy for advanced NSCLC patients as second-line therapy, but the results on efficacy such are inconsistent. The aim this meta-analysis was and safety EGFR-TKI who failed first-line treatment. Materials Methods: We searched relative from PubMed, EMBASE, ASCO Abstracts, ESMO Cochrane Library Clinical Trials.gov. Outcomes analyzed were overall response rate (ORR), progression- free survival (PFS), (OS) major toxicity. Results: Seven trails eventually included in meta-analysis, covering 1,168 patients. showed that combined regimen arm had significant higher ORR (RR 1.76 [1.16, 2.66], p=0.007) longer PFS (HR 0.75 [0.66-0.85], p<0.00001), show effects OS 0.88 [0.68- 1.15], p=0.36). In terms subgroup results, continuation addition after resistance confered no improvement 0.95 [0.68, 1.33], p=0.75) 0.89[0.69, p=0.38), even shorter (HR1.52 [1.05- 2.21], p=0.03). However, therapy failure significantly improved 2.06 [1.42, 2.99], p=0.0002), 0.71 [0.61, 0.82], p<0.00001) 0.74 [0.62- 0.88], p=0.0008), benefit being restricted combining pemetrexed, not docetaxel. Grade 3-4 toxicity found at incidence arm. Conclusions: Continuation should be avoided. Combination pemetrexed further investigated prognostic predictive factors find group highest strategy.