PMID- 25471638
OWN - NLM
STAT- MEDLINE
DCOM- 20150731
LR  - 20220325
IS  - 1097-0215 (Electronic)
IS  - 0020-7136 (Linking)
VI  - 137
IP  - 2
DP  - 2015 Jul 15
TI  - Safety profile of combined therapy inhibiting EFGR and VEGF pathways in patients 
      with advanced non-small-cell lung cancer: A meta-analysis of 15 phase II/III 
      randomized trials.
PG  - 409-19
LID - 10.1002/ijc.29377 [doi]
AB  - The efficacy of combined vascular endothelial growth factor (VEGF) and epidermal 
      growth factor receptor (EGFR) inhibition in patients with advanced non-small-cell 
      lung cancer (NSCLC) was well studied. However, few studies focused on the risk 
      and adverse events (AEs) of combined targeted therapy. The aim of this 
      meta-analysis was to evaluate the safety profile of combined targeted therapy 
      against EFGR and VEGF in patients with advanced NSCLC. A comprehensive literature 
      search in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials 
      (CENTRAL), ASCO Abstracts and ESMO Abstracts was conducted. Eligible studies were 
      randomized clinical trials (RCTs) that compared safety profile of combined 
      therapy inhibiting EFGR and VEGF pathways with control groups (placebo, single 
      EGFR or VEGF inhibition therapy, chemotherapy or a combination of them) in 
      patients with advanced NSCLC. The endpoints included treatment discontinuation, 
      treatment-related deaths and AEs. The search identified 15 RCTs involving 6,919 
      patients. The outcomes showed that three of four pairwise comparisons detected 
      more discontinuation due to AEs in combined targeted therapy, with odds ratio 
      (OR) compared with the control groups ranged from 1.97 to 2.29. Treatment with 
      combined inhibition therapy was associated with several all-grade and grade 3 or 
      4 AEs (e.g. rash, diarrhea and hypertension). Also, there was a significantly 
      higher incidence of treatment-related deaths in combined inhibition using 
      vandetanib versus single EGFR inhibition therapy (OR = 1.97, 95% CI 1.19-3.28). 
      In conclusion, combined inhibition therapy against EGFR and VEGF in patients with 
      advanced NSCLC was associated with increased toxicity. Increased AEs hinder 
      patient compliance and reduce their quality of life, leading to dose reduction or 
      discontinuation.
CI  - (c) 2014 UICC.
FAU - Ma, Wang
AU  - Ma W
AD  - Department of Oncology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, China.
FAU - Xu, Mingxin
AU  - Xu M
AD  - Department of Gastroenterology, Tongji Hospital, Tongji University School of 
      Medicine, Shanghai, China.
FAU - Liu, Yiqian
AU  - Liu Y
AD  - Department of Oncology, The First Affiliated Hospital with Nanjing Medical 
      University, Nanjing, China.
FAU - Liu, Hao
AU  - Liu H
AD  - Department of Medical Sciences, Biology and Biomedical Sciences, Harvard Medical 
      School, Boston, MA.
FAU - Huang, Jiale
AU  - Huang J
AD  - Department of Gastroenterology, Tongji Hospital, Tongji University School of 
      Medicine, Shanghai, China.
FAU - Zhu, Yanjie
AU  - Zhu Y
AD  - Department of Gastroenterology, Tongji Hospital, Tongji University School of 
      Medicine, Shanghai, China.
FAU - Ji, Li-Juan
AU  - Ji LJ
AD  - Department of Rehabilitation, The Second People's Hospital of Huai'an, Huai'an, 
      China.
FAU - Qi, Xiaolong
AU  - Qi X
AD  - Department of Oncology, The First Affiliated Hospital of Zhengzhou University, 
      Zhengzhou, China.
AD  - Department of Gastroenterology, Tongji Hospital, Tongji University School of 
      Medicine, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20141212
PL  - United States
TA  - Int J Cancer
JT  - International journal of cancer
JID - 0042124
RN  - 0 (Piperidines)
RN  - 0 (Quinazolines)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - DA87705X9K (Erlotinib Hydrochloride)
RN  - EC 2.7.10.1 (ErbB Receptors)
RN  - YO460OQ37K (vandetanib)
SB  - IM
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/metabolism
MH  - Clinical Trials, Phase II as Topic
MH  - Clinical Trials, Phase III as Topic
MH  - Diarrhea/chemically induced
MH  - ErbB Receptors/*antagonists & inhibitors/metabolism
MH  - Erlotinib Hydrochloride
MH  - Exanthema/chemically induced
MH  - Fatigue/chemically induced
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/metabolism
MH  - Outcome Assessment, Health Care
MH  - Piperidines/administration & dosage/adverse effects
MH  - Quinazolines/administration & dosage/adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Signal Transduction/drug effects
MH  - Vascular Endothelial Growth Factor A/*antagonists & inhibitors/metabolism
OTO - NOTNLM
OT  - EGFR
OT  - VEGF
OT  - adverse events
OT  - non-small-cell lung cancer
OT  - randomized clinical trial
OT  - targeted therapy
EDAT- 2014/12/05 06:00
MHDA- 2015/08/01 06:00
CRDT- 2014/12/05 06:00
PHST- 2014/11/01 00:00 [received]
PHST- 2014/11/19 00:00 [accepted]
PHST- 2014/12/05 06:00 [entrez]
PHST- 2014/12/05 06:00 [pubmed]
PHST- 2015/08/01 06:00 [medline]
AID - 10.1002/ijc.29377 [doi]
PST - ppublish
SO  - Int J Cancer. 2015 Jul 15;137(2):409-19. doi: 10.1002/ijc.29377. Epub 2014 Dec 
      12.