PMID- 34964780
OWN - NLM
STAT- MEDLINE
DCOM- 20220131
LR  - 20230103
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 47
DP  - 2021 Nov 24
TI  - Anti-EGFR monoclonal antibody plus chemotherapy for treating advanced non-small 
      cell lung cancer: A meta-analysis.
PG  - e27954
LID - 10.1097/MD.0000000000027954 [doi]
LID - e27954
AB  - BACKGROUND: The use of standard cytotoxic chemotherapy seems to have reached a 
      "treatment plateau". The application of anti-epidermal growth factor receptor 
      (EGFR) monoclonal antibodies (mAbs) is a new strategy for non-small-cell lung 
      cancer (NSCLC) therapy. We aimed to comprehensively assess the efficacy and 
      safety of anti-EGFR-mAbs plus chemotherapy as first-line therapy for advanced 
      NSCLC. METHODS: According to inclusion and exclusion criteria, we conducted a 
      comprehensive literature search of electronic databases. From the included 
      trials, information on overall survival (OS), progression-free survival (PFS), 
      objective response rate (ORR), and adverse events (AEs) was extracted. RESULTS: 
      The research showed that compared with chemotherapy alone, anti-EGFR-mAb plus 
      chemotherapy combinations significantly improved OS (HR = 0.88, 95%CI: 0.83-0.94, 
      P < .0001), PFS (HR = 0.89, 95%CI: 0.83-0.95, P = 0.0004) and ORR (OR = 1.39, 
      95%CI: 1.13-1.69, P = .001). Meta subgroup analyses manifested that the OS of 
      patients with squamous NSCLC treated with anti-EGFR-mAb plus chemotherapy 
      combinations was notably better than that of patients with non-squamous NSCLC 
      treated with the same combinations (HR = 0.82, 95%CI: 0.73-0.92, P = .0005). 
      Compared with the chemotherapy group, combination of chemotherapy and anti-EGFR 
      mAb showed increase in incidences of severe AEs (> = grade 3) that mainly 
      include, leukopenia (OR = 1.53, 95%CI: 1.28-1.82, P < .00001), febrile 
      neutropenia (OR = 1.35, 95%CI: 1.06-1.71, P = .02), hypomagnesemia (OR = 5.68, 
      95%CI: 3.54-9.10, P < .00001), acneiform rash (OR = 35.88, 95%CI: 17.37-74.10, 
      P < .00001), fatigue (OR = 1.24, 95%CI: 1.02-1.49, P = .03), diarrhea (OR = 1.69, 
      95%CI: 1.16-2.47, P = .006), and infusion-related reactions (OR = 3.78, 95%CI: 
      1.93-7.41, P = .0001). CONCLUSION: Adding an anti-EGFR-mAb to the standard 
      platinum-based chemotherapy regimens used for the first-line treatment of 
      advanced NSCLC resulted in statistically notable improvements in OS, PFS, and 
      ORR. In particular, anti-EGFR-mAb and chemotherapy combinations achieved greater 
      survival benefits in patients with squamous NSCLC than in those with non-squamous 
      NSCLC. In addition, the safety profile of chemotherapy plus anti-EGFR-mAb 
      combinations was acceptable compared to that of chemotherapy alone.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Luo, Wenqing
AU  - Luo W
AD  - Department of thoracic surgery, First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, Henan Province, China.
FAU - Li, Yuanqi
AU  - Li Y
AD  - XiangYa School of Public Health, Central South University, Changsha, Hunan 
      Province, China.
FAU - Ye, Fei
AU  - Ye F
AD  - Department of thoracic surgery, First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, Henan Province, China.
FAU - Li, Qiangming
AU  - Li Q
AD  - Department of thoracic surgery, First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, Henan Province, China.
FAU - Zhang, Guoqing
AU  - Zhang G
AD  - Department of thoracic surgery, First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, Henan Province, China.
FAU - Li, Jindong
AU  - Li J
AD  - Department of thoracic surgery, First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, Henan Province, China.
FAU - Li, Xiangnan
AU  - Li X
AD  - Department of thoracic surgery, First Affiliated Hospital of Zhengzhou 
      University, Zhengzhou, Henan Province, China.
LA  - eng
GR  - 32070623/National Natural Science Foundation of China/
PT  - Journal Article
PT  - Meta-Analysis
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antineoplastic Agents)
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  - Antibodies, Monoclonal/adverse effects/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized/*therapeutic use
MH  - Antineoplastic Agents/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/genetics/mortality
MH  - Carcinoma, Squamous Cell/drug therapy
MH  - ErbB Receptors
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/genetics/mortality
MH  - Protein Kinase Inhibitors/therapeutic use
PMC - PMC8615333
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/12/30 06:00
MHDA- 2022/02/01 06:00
PMCR- 2021/11/24
CRDT- 2021/12/29 12:22
PHST- 2021/06/02 00:00 [received]
PHST- 2021/11/03 00:00 [accepted]
PHST- 2021/12/29 12:22 [entrez]
PHST- 2021/12/30 06:00 [pubmed]
PHST- 2022/02/01 06:00 [medline]
PHST- 2021/11/24 00:00 [pmc-release]
AID - 00005792-202111240-00055 [pii]
AID - MD-D-21-04006 [pii]
AID - 10.1097/MD.0000000000027954 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Nov 24;100(47):e27954. doi: 
      10.1097/MD.0000000000027954.