PMID- 33067126 OWN - NLM STAT- MEDLINE DCOM- 20211214 LR - 20211214 IS - 1938-0690 (Electronic) IS - 1525-7304 (Linking) VI - 22 IP - 1 DP - 2021 Jan TI - Role of Antiangiogenic Agents Combined With EGFR Tyrosine Kinase Inhibitors in Treatment-naive Lung Cancer: A Meta-Analysis. PG - e70-e83 LID - S1525-7304(20)30271-0 [pii] LID - 10.1016/j.cllc.2020.08.005 [doi] AB - BACKGROUND: Antiangiogenic agents combined with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are considered potentially effective biologically synergistic drug combinations for EGFR-mutant advanced non-small-cell lung cancer (NSCLC), although some controversy remains. The European Commission has approved the use of bevacizumab plus erlotinib as first-line treatment of EGFR-mutated NSCLC; however, it has not yet been approved by the U.S. Food and Drug Administration. Recently, several phase III, randomized controlled trials of combinations of antiangiogenic agents and EGFR-TKIs have been reported. These studies have not yet been included in any previous meta-analysis. MATERIALS AND METHODS: We performed a meta-analysis to compare antiangiogenic agents plus EGFR-TKIs versus EGFR-TKIs alone for treatment of EGFR-mutant NSCLC. The main outcomes were progression-free survival (PFS), overall survival (OS), the objective response rate (ORR), and adverse events (AEs). RESULTS: We identified 9 previous reports of 6 randomized controlled trials and 1 prospective cohort study, involving 1295 patients. Compared with EGFR-TKIs alone, antiangiogenic agents plus EGFR-TKIs resulted in a higher PFS (hazard ratio, 0.58; 95% confidence interval [CI], 0.50-0.67; P < .001). However, no significant differences in OS (hazard ratio, 0.79; 95% CI, 0.53-1.18; P = .26) and ORR (risk ratio, 1.03; 95% CI, 0.97-1.10; P = .30) were found between the 2 groups. An increased risk of serious AEs (risk ratio, 1.41; 95% CI, 1.11-1.79; P = .005) was found in the combination drug therapy group. CONCLUSIONS: Antiangiogenic agents plus EGFR-TKIs enhanced PFS for patients with EGFR-mutant NSCLC but with a greater risk of serious AEs. No significant benefits for OS and ORR were found between the 2 groups. CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Deng, Zhujun AU - Deng Z AD - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China; Precision Medicine Key Laboratory of Sichuan Province, Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, China. FAU - Qin, Yun AU - Qin Y AD - Department of Radiology, West China Hospital, Sichuan University, Chengdu, China. FAU - Liu, Yongmei AU - Liu Y AD - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China. FAU - Zhang, Yan AU - Zhang Y AD - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China. Electronic address: zhang.yan@scu.edu.cn. FAU - Lu, You AU - Lu Y AD - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China. LA - eng SI - ClinicalTrials.gov/NCT02633189 SI - ClinicalTrials.gov/NCT02655536 SI - ClinicalTrials.gov/NCT03126799 SI - ClinicalTrials.gov/NCT02971501 SI - ClinicalTrials.gov/NCT02824458 PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't DEP - 20200918 PL - United States TA - Clin Lung Cancer JT - Clinical lung cancer JID - 100893225 RN - 0 (Angiogenesis Inhibitors) RN - 0 (Protein Kinase Inhibitors) RN - EC 2.7.10.1 (EGFR protein, human) RN - EC 2.7.10.1 (ErbB Receptors) SB - IM MH - Angiogenesis Inhibitors/*therapeutic use MH - Drug Therapy, Combination MH - ErbB Receptors/antagonists & inhibitors MH - Humans MH - Lung Neoplasms/*drug therapy/pathology MH - Prognosis MH - Protein Kinase Inhibitors/*therapeutic use OTO - NOTNLM OT - Antiangiogenic agents OT - Bevacizumab OT - Combination therapy OT - EGFR-TKIs OT - Non-small-cell lung cancer OT - Ramucirumab EDAT- 2020/10/18 06:00 MHDA- 2021/12/15 06:00 CRDT- 2020/10/17 05:24 PHST- 2020/06/15 00:00 [received] PHST- 2020/08/11 00:00 [revised] PHST- 2020/08/25 00:00 [accepted] PHST- 2020/10/18 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2020/10/17 05:24 [entrez] AID - S1525-7304(20)30271-0 [pii] AID - 10.1016/j.cllc.2020.08.005 [doi] PST - ppublish SO - Clin Lung Cancer. 2021 Jan;22(1):e70-e83. doi: 10.1016/j.cllc.2020.08.005. Epub 2020 Sep 18.