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[A Systematic Review of Erlotinib for Advanced Non-small Cell Lung Cancer.]
Huiling Guo1, Rongfang Zhang, Qimei Yang
1Evidence Based Medicine Center of Lanzhou University, Lanzhou 730000, China; The Second Clinical Medical college of Lanzhou University, Lanzhou 730000, China.
Background:
It was unclear whether advanced non-small cell lung cancer (NSCLC) patients could benefit from erlotinib therapy. This study was aimed to evaluate the efficacy and safety of NSCLC patients treated with erlotinib.
Methods:
The relevant randomized controlled trials (RCT) were searched from VIP, CMB, CNKI, PubMed, EMBASE and The Cochrane Library. The related references and experts in this field were traced, and other authors were communicated with to obtain the information that has not been found. Quality assessment of qualified RCTs assessed by the exclusion and inclusion criteria and RevMan 5.0 provided by the Cochrane Collaboration was used to perform meta-analysis.
Results:
Three RCTs involving 2 969 patients were included. Meta analysis results suggested that erlotinib was superior to placebo for one year survival rate (OR=1.18, 95%CI: 1.01-1.38), tumor response rate (OR=1.24, 95%CI: 1.03-1.49), median overall survival, median progression-free survival and tumor responses duration. At the same time, the incidence of grade 3-4 skin rash (OR=16.33, 95%CI: 7.01-38.02) and diarrhea (OR=5.02, 95%CI: 2.93-8.60) of the adverse reactions was increased.
Conclusions:
Advanced non-small cell lung cancer patients could benefit from Erlotinib therapy, but the incidence of skin rash and diarrhea was significantly increased, and in the absence of damage to the blood system, serious liver and kidney damage, cardiac toxicity, etc, there were no difference with placebo.
Insights
Erlotinib improves survival and tumor response rates in advanced non-small cell lung cancer (NSCLC) patients. However, it significantly increases the risk of skin rash and diarrhea, with no observed differences in other serious toxicities compared to placebo.
Area of Science:
- Oncology
- Pharmacology
Context:
- Advanced non-small cell lung cancer (NSCLC) presents significant treatment challenges.
- The efficacy of erlotinib in this patient population was previously unclear.
Purpose:
- To evaluate the efficacy and safety of erlotinib therapy in advanced non-small cell lung cancer (NSCLC) patients through a meta-analysis of randomized controlled trials (RCTs).
Summary:
- Meta-analysis of three RCTs (2,969 patients) indicated erlotinib improved one-year survival rates, tumor response rates, median overall survival, and progression-free survival compared to placebo.
- Erlotinib treatment was associated with a significantly increased incidence of grade 3-4 skin rash and diarrhea.
- No significant differences were observed in blood system damage, serious liver/kidney damage, or cardiac toxicity between erlotinib and placebo groups.
Impact:
- Erlotinib offers a survival benefit for advanced NSCLC patients.
- Clinicians should be aware of and manage the increased risk of dermatological and gastrointestinal side effects.
- The findings support erlotinib as a therapeutic option while highlighting the need for vigilant monitoring of adverse events.
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