The efficacy and toxicity of afatinib in advanced EGFR-positive non-small-cell lung cancer patients after failure of first-generation tyrosine kinase inhibitors: a systematic review and meta-analysis
Background: The first generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), gefitinib and erlotinib, have become the standard first-line treatment for non-small-cell lung cancer (NSCLC) patients with EGFR mutation. However, there was no pooled analysis focused on the usage of the second-generation TKI, afatinib, in advanced EGFR-positive NSCLC patients after failure of first generation TKIs. Therefore, a meta-analysis was conducted to solve the above question. Methods: Electronic databases were searched for eligible literatures. ORR (objective response rate), DCR (disease controlled rate), PFS (progression-free survival), OS (overall survival) and primary grade 3/4 adverse events were pooled with the corresponding 95% confidence interval using R software. Sensitivity analyses and heterogeneity were quantitatively evaluated. Results: A total of 545 EGFR-positive patients were available for analysis from five studies after detailed screening from 909 relevant studies. The pooled ORR and DCR of afatinib in EGFR-positive patients after failure of the first generation EGFR-TKIs were 0.12 (0.08-0.19) and 0.60 (0.53-0.68), respectively. Besides, the 6 m-PFS rate, 1 y-PFS rate and 6 m-OS rate were 0.26 (0.22-0.30), 0.08 (0.06-0.10) and 0.74 (0.56-0.86). The grade 3/4 rate of diarrhea and that of skin deformity were 0.23 (0.10-0.46) and 0.14 (0.05-0.33), respectively. Sensitivity analyses revealed similar results with lower heterogeneity. Conclusions: Considering the efficacy, toxicity and current availability, afatinib could be a therapeutic option for advanced EGFR mutated NSCLC patients after the failure of 1st-generation TKIs.
基金:
National Key R&D Program of China [2016YFC0905500]
语种:
外文
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2017]版:
大类|4 区医学
小类|4 区呼吸系统
最新[2023]版:
大类|3 区医学
小类|4 区呼吸系统
第一作者:
第一作者机构:[1]Sun Yat Sen Univ, Dept Med Oncol, Ctr Canc, 651 Dongfeng Rd East, Guangzhou 510060, Guangdong, Peoples R China;[2]State Key Lab Oncol South China, Guangzhou 510080, Guangdong, Peoples R China;[3]Collaborat Innovat Ctr Canc Med, Guangzhou 510060, Guangdong, Peoples R China;
通讯作者:
通讯机构:[1]Sun Yat Sen Univ, Dept Med Oncol, Ctr Canc, 651 Dongfeng Rd East, Guangzhou 510060, Guangdong, Peoples R China;[2]State Key Lab Oncol South China, Guangzhou 510080, Guangdong, Peoples R China;[3]Collaborat Innovat Ctr Canc Med, Guangzhou 510060, Guangdong, Peoples R China;
推荐引用方式(GB/T 7714):
Zhang Yaxiong,Miao Siyu,Wang Fang,et al.The efficacy and toxicity of afatinib in advanced EGFR-positive non-small-cell lung cancer patients after failure of first-generation tyrosine kinase inhibitors: a systematic review and meta-analysis[J].JOURNAL OF THORACIC DISEASE.2017,9(7):1980-1987.doi:10.21037/jtd.2017.06.08.
APA:
Zhang, Yaxiong,Miao, Siyu,Wang, Fang,Fang, Wenfeng,Chen, Gang...&Zhang, Li.(2017).The efficacy and toxicity of afatinib in advanced EGFR-positive non-small-cell lung cancer patients after failure of first-generation tyrosine kinase inhibitors: a systematic review and meta-analysis.JOURNAL OF THORACIC DISEASE,9,(7)
MLA:
Zhang, Yaxiong,et al."The efficacy and toxicity of afatinib in advanced EGFR-positive non-small-cell lung cancer patients after failure of first-generation tyrosine kinase inhibitors: a systematic review and meta-analysis".JOURNAL OF THORACIC DISEASE 9..7(2017):1980-1987