|Table of Contents|

Efficacy analysis of first-line EGFR-TKIs combined with angiogenesis inhibitors in the treatment of advanced EGFR mutated non-small cell lung cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 11
Page:
2042-2048
Research Field:
Publishing date:

Info

Title:
Efficacy analysis of first-line EGFR-TKIs combined with angiogenesis inhibitors in the treatment of advanced EGFR mutated non-small cell lung cancer
Author(s):
LIU Na; ZHANG Mi; JIANG Aimin; RUAN Zhiping; YAO Yu
Department of Medical Oncology,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China.
Keywords:
EGFR-TKI; angiogenesis inhibitors; non-small cell lung cancer; meta-analysis
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2023.11.013
Abstract:
Objective:To compare the efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) plus angiogenesis inhibitors versus EGFR-TKIs monotherapy as the first-line treatment for EGFR-mutated advanced non-small cell lung cancer(NSCLC) patients.Methods:Databases from PubMed,Embase,Web of Science,Cochrane Library,the European Society of Medical Oncology (ESMO) conference abstract,and the American Society of Clinical Oncology (ASCO) conference abstract up to November 13,2020.STATA version 14.0 was used for statistical tests.Results:There were six phase II/III randomized controlled trails (RCTs) from 11 articles,encompassing 1 537 patients eligible for meta-analysis.The results suggested that EGFR-TKIs plus angiogenesis inhibitors had remarkably prolonged progression-free survival (PFS) ［hazard ratio(HR)=0.62,95% confidence interval(CI) 0.54~0.70,P<0.001］.However,the combination group failed to improve overall survival (OS) (P=0.536),objective response rate (ORR) (P=0.186),and disease control rate (DCR) (P=0.918).The risk of overall grade 3 or higher adverse events ［risk ratio(RR)=1.80,95%CI 1.46~2.22,P<0.001］and serious adverse events (RR=1.48,95%CI 1.22~1.81,P<0.001) were significantly increased in the combination group.Among them,the incidence of proteinuria,hypertension and diarrhea in the combination group was significantly increased.In addition,subgroup analysis showed that patients with exon 19 deletions (HR=0.62,95%CI 0.51~0.75,P<0.001) and exon 21 Leu858Arg mutation (HR=0.62,95%CI 0.51~0.75,P<0.001) had similar benefits in the combination group.Conclusion:EGFR-TKIs plus angiogenesis inhibitors as the first-line treatment can prolong PFS of advanced NSCLC patients with EGFR mutations.Although the incidence of AEs in the combination group increased,the toxicity could be tolerable and manageable.Thus,the combination therapy can be used as the first-line option for advanced patients with EGFR mutations.

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Last Update: 2023-04-28