Systems assessment of intercalated combination of chemotherapy and EGFR TKIs versus chemotherapy or EGFR TKIs alone in advanced NSCLC patients.
Systems assessment of intercalated combination of chemotherapy and EGFR TKIs versus chemotherapy or EGFR TKIs alone in advanced NSCLC patients.
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在晚期 NSCLC 患者中，对化疗和 EGFR TKI 间插组合与单独化疗或 EGFR TKI 进行系统评估。
DOI：
10.1038/srep15355
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发表时间：
2015-10-20
影响因子：
4.6
通讯作者：
Cao B
中科院分区：
文献类型：
--
作者：
Yan H;Li Q;Wang W;Zhen H;Cao B
化疗和表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)均被广泛应用于非小细胞肺癌(NSCLC)的治疗，但两者联合治疗的疗效尚不明确。因此，我们试图评估这两种治疗方法在非小细胞肺癌中的疗效。两名研究人员系统地检索了PubMed数据库、EMBASE数据库、Cochrane对照试验注册数据库和中国生物医学数据库，进行了随机临床试验(RCT)，以检查化疗和EGFR TKI在非小细胞肺癌中的嵌入组合。这项系统性综述包括10项研究，涉及1,660名患者。统计结果显示，与单纯化疗相比，联合化疗和EGFR TKI可显著提高患者的总生存期(OS)(风险比(HR) = 为0.83，95%可信区间(CI)：0.70~0.98)、无进展生存率(HR = 为0.65，95%CI：0.51~0.84)和客观有效率(RRR， = 1.90，95%CI：1.22~2.98)。同样，在晚期非小细胞肺癌的治疗中，化疗和EGFR TKI的联合应用似乎优于单独应用EGFR TKIs(PFS：HR = 0.75，95%CI：0.62~0.91；ORR：RR = 1.49，95%CI：1.12~2.00；DCR：RR = 1.33，95%CI：1.15~1.54)。
Both chemotherapy and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) are widely applied for the treatment of non-small cell lung cancer (NSCLC), but the efficacy of these two treatments in combination is not yet clear. Thus, we sought to evaluate the efficacy of the intercalated combination of these two treatments in NSCLC. The PubMed database, EMBASE, Cochrane Controlled Trials Register, and Chinese Biomedical Database were systematically searched by two researchers for randomized clinical trials (RCTs) that examined the intercalated combination of chemotherapy and EGFR TKIs in NSCLC. Ten studies involving 1,660 patients were included in this systematic review. The statistical results showed that the intercalated combination of chemotherapy and EGFR TKIs significantly improved overall survival (OS) (hazard ratio (HR) = 0.83, 95% confidence interval (CI): 0.70–0.98), progression-free survival (PFS) (HR = 0.65, 95% CI: 0.51–0.84), and the objective response rate (ORR) (risk ratio (RR) = 1.90, 95% CI: 1.22–2.98) compared to chemotherapy alone. Similarly, compared to EGFR TKIs monotherapy, the intercalated combination of chemotherapy and EGFR TKIs seemed superior to EGFR TKIs alone in terms of PFS, ORR and DCR (PFS: HR = 0.75, 95% CI: 0.62–0.91, ORR: RR = 1.49, 95% CI: 1.12–2.00 and DCR: RR = 1.33, 95% CI: 1.15–1.54) in advanced NSCLC therapy.