Comparative efficacy and safety of first-line EGFR-TKIs for advanced non-small cell lung cancer:a network meta-analysis

ZHANG Hui-fang; MA Jin-sha; LI Lu; GAO Qian; WANG Tong

doi:10.16462/j.cnki.zhjbkz.2020.02.017

Volume 24 Issue 2

Feb. 2020

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Article Navigation > CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION > 2020 > 24(2): 210-216

ZHANG Hui-fang, MA Jin-sha, LI Lu, GAO Qian, WANG Tong. Comparative efficacy and safety of first-line EGFR-TKIs for advanced non-small cell lung cancer:a network meta-analysis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2020, 24(2): 210-216. doi: 10.16462/j.cnki.zhjbkz.2020.02.017

Citation:

ZHANG Hui-fang, MA Jin-sha, LI Lu, GAO Qian, WANG Tong. Comparative efficacy and safety of first-line EGFR-TKIs for advanced non-small cell lung cancer:a network meta-analysis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2020, 24(2): 210-216. doi: 10.16462/j.cnki.zhjbkz.2020.02.017

Citation:

ZHANG Hui-fang, MA Jin-sha, LI Lu, GAO Qian, WANG Tong. Comparative efficacy and safety of first-line EGFR-TKIs for advanced non-small cell lung cancer:a network meta-analysis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2020, 24(2): 210-216. doi: 10.16462/j.cnki.zhjbkz.2020.02.017

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Comparative efficacy and safety of first-line EGFR-TKIs for advanced non-small cell lung cancer:a network meta-analysis

doi: 10.16462/j.cnki.zhjbkz.2020.02.017

Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan 030001, China

Funds: National Natural Science Foundation of China(81872715)

More Information

Corresponding author: WANG Tong, E-mail:tongwang@sxmu.edu.cn
Received Date: 2019-07-13
Rev Recd Date: 2019-10-08
Publish Date: 2020-02-10

Abstract

Abstract

Objective To compare the efficacy and safety of gefitinib, erlotinib, and afatinib in the first-line treatment of advanced non-small cell lung cancer(NSCLC). Methods PubMed, EMBASE, and The Cochrane Library were searched to identify the relevant literatures published from December 2008 to December 2018. Bayesian network meta-analysis was carried out to rank the three treatments. Results A total of ten eligible studies involving 2275 patients were enrolled. In terms of efficacy, the surface under the cumulative ranking(SUCRA) indicated that erlotinib performed best in progression-free survival(PFS)(0.88), afatinib performed best in objective response rate(ORR)(0.82) and disease control rate(DCR)(0.86), gefitinib performed worst in PFS(0.45), ORR(0.42), and DCR(0.45). For safety, the differences of grade 3 or 4 adverse events rate(OR=0.29, 95%CI:0.08-0.98) and discontinuation rate(OR=0.14, 95%CI:0.01-0.8) between erlotinib and the platinum-based doublet chemotherapy were statistically significant. The ranking results also supported that erlotinib was the safest. SUCRA results suggested that gefitinib(0.31) had a lower grade 3 or 4 adverse events rate than afatinib(0.57), and the possibility of discontinuation in gefitinib(0.44) was similar to that of afatinib(0.41). Conclusion Erlotinib might be the preferred first-line treatment for advanced NSCLC after weighing and balancing the benefits and risks.
- Non-small cell lung cancer,
- Gefitinib,
- Erlotinib,
- Afatinib,
- First-line treatment,
- Network meta-analysis

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References(28)

References

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