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Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
Published on: August 11, 2017
EGFR-targeted therapies combined with chemotherapy for treating advanced non-small-cell lung cancer: a meta-analysis
Peng Chen1, Long Wang, Bing Liu
1Department of Stomatology, Chinese People's Liberation Army General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China.
Purpose:
The epidermal growth factor receptor (EGFR) is one of the four human epidermal receptors. The efficacy and safety of EGFR-targeted therapies for treating non-small-cell lung cancer (NSCLC) remained controversial. The aim of this study was to systematically evaluate EGFR-targeted therapies plus chemotherapy for advanced NSCLC.
Methods:
Cochrane Central Register of Controlled Trials, PubMed, and Embase were searched for relevant studies. Quantitative analysis was carried out to evaluate survival, response, and toxicity of EGFR-targeted therapies.
Results:
Ten randomized controlled trials (RCTs) involving 5,936 patients were identified out of 107 studies. There was no statistical difference in overall (OS) and 1-year (OYS) survival rate when small-molecule tyrosine kinase inhibitors (TKIs) plus platinum-based doublet chemotherapy (PBDC) were compared with PBDC alone. However, progression-free survival [hazard ratio (HR)=0.87, 95% confidence interval (CI) 0.76-0.99] and overall response rate (ORR) were marginally improved. Prolonged OS (HR=0.87, 95% CI 0.78-0.96) and increased ORR and OYS were found when cetuximab plus PBDC was compared with PBDC alone. Adverse events in the combination arms were similar in incidence to those of the chemotherapy-alone arms, with the exception of an increased incidence of rash and diarrhea.
Conclusions:
Cetuximab adds benefits to NSCLC patients compared with PBDC alone. Small-molecule TKIs plus PBDC lead to a slightly additive efficacy compared with PBDC alone.
Insights
Cetuximab combined with chemotherapy improves outcomes for advanced non-small-cell lung cancer (NSCLC) patients. Small-molecule tyrosine kinase inhibitors offer marginal benefits when added to chemotherapy for NSCLC.
Area of Science:
- Oncology
- Pharmacology
Background:
- Epidermal growth factor receptor (EGFR) is a key target in cancer therapy.
- The role of EGFR-targeted therapies combined with chemotherapy in advanced non-small-cell lung cancer (NSCLC) requires clarification.
Purpose of the Study:
- To systematically evaluate the efficacy and safety of EGFR-targeted therapies plus chemotherapy for advanced NSCLC.
- To compare outcomes of combination therapies versus chemotherapy alone.
Main Methods:
- Systematic review and quantitative analysis of randomized controlled trials (RCTs).
- Searches conducted in Cochrane Central Register of Controlled Trials, PubMed, and Embase.
- Evaluation of survival rates, response, and toxicity.
Main Results:
- Ten RCTs involving 5,936 patients were analyzed.
- Cetuximab plus platinum-based doublet chemotherapy (PBDC) showed prolonged overall survival (OS), increased overall response rate (ORR), and 1-year survival (OYS) compared to PBDC alone.
- Small-molecule tyrosine kinase inhibitors (TKIs) plus PBDC demonstrated marginally improved progression-free survival and ORR, with no significant difference in OS or OYS.
Conclusions:
- Cetuximab offers significant benefits when added to PBDC for advanced NSCLC.
- Small-molecule TKIs provide a slight additive efficacy when combined with PBDC in NSCLC treatment.
- Adverse events were comparable, except for increased rash and diarrhea with combination therapies.
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