PMID- 37779240
OWN - NLM
STAT- MEDLINE
DCOM- 20240104
LR  - 20240104
IS  - 1537-453X (Electronic)
IS  - 0277-3732 (Linking)
VI  - 46
IP  - 12
DP  - 2023 Dec 1
TI  - A Meta-analysis of Randomised Controlled Trials Comparing Combination Therapy as 
      Second-line Treatment With Monotherapy in Advanced Non-small Cell Lung Cancer 
      With Epidermal Growth Factor Receptor Mutation.
PG  - 551-558
LID - 10.1097/COC.0000000000001047 [doi]
AB  - BACKGROUND: Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors 
      are standard therapy for patients with non-small cell lung cancer (NSCLC) with 
      EGFR mutation; however, resistance is common. Combinatorial strategies have been 
      explored to improve survival. This meta-analysis assesses the efficacy and safety 
      of combination therapy versus monotherapy in patients with advanced NSCLC who 
      failed first-line EGFR-tyrosine kinase inhibitor treatment. METHODS: We searched 
      randomized controlled trials from PubMed, Web of Science, Google Scholar, 
      Cochrane Library, and ClinicalTrial.gov. The efficacy and toxicity of combination 
      treatment groups were assessed in terms of progression-free survival (PFS), 
      overall response rate (ORR), disease control rate (DCR), and adverse events 
      (AEs). RESULTS: This meta-analysis included 6 randomized controlled trials 
      covering 785 participants. The results showed that the combined regimen arm had 
      no significant improvement of PFS (log hazard ratio = -0.228, 95% CI: -0.543 to 
      0.087, P = 0.157), ORR (odds ratio = 1.147 [95% CI: 0.577, 2.281], P = 0.695), 
      DCR (odds ratio = 1.578 [95% CI: 0.428, 5.821], P = 0.493), and AEs, including 
      fatigue and diarrhea (odds ratio = 0.833 [95% CI: 0.297, 2.333], P = 0.728 for 
      fatigue and odds ratio = 2.268 [95% CI: 0.544, 9.448], P = 0.261 for diarrhea). 
      CONCLUSIONS: Combination therapy may not provide a significant improvement in 
      PFS, ORR, DCR, and incidence of AEs compared with monotherapy in patients with 
      advanced NSCLC with EGFR mutations. Further research is needed to investigate the 
      optimal sequencing of combination therapy in patients with NSCLC with different 
      molecular targets to determine the most effective treatment strategy that can 
      improve outcomes and quality of life for these patients.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Zhao, Kai-Xiang
AU  - Zhao KX
AD  - Department of Thoracic Surgery.
FAU - Zhang, Yan-Fang
AU  - Zhang YF
AD  - Department of Nephrology, 903 Hospital of Joint Service Support Force of Chinese 
      People's Liberation Army, Hangzhou city, Zhejiang province, China.
FAU - Zheng, Lei
AU  - Zheng L
AD  - Department of Breast Surgery.
FAU - Pan, Ya-Fei
AU  - Pan YF
AD  - Department of Anesthesiology, Zhejiang Cancer Hospital, Hangzhou.
FAU - He, Ze-Huang
AU  - He ZH
AD  - Department of Vascular Surgery, Zhejiang Hospital.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20231002
PL  - United States
TA  - Am J Clin Oncol
JT  - American journal of clinical oncology
JID - 8207754
RN  - EC 2.7.10.1 (EGFR protein, human)
RN  - EC 2.7.10.1 (ErbB Receptors)
RN  - 0 (Tyrosine Kinase Inhibitors)
SB  - IM
MH  - Randomized Controlled Trials as Topic
MH  - Humans
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy/genetics
MH  - *Lung Neoplasms/drug therapy/genetics
MH  - ErbB Receptors/genetics
MH  - *Tyrosine Kinase Inhibitors/therapeutic use
MH  - Drug Therapy, Combination
COIS- The authors declare no conflicts of interest.
EDAT- 2023/10/02 06:42
MHDA- 2023/11/22 06:42
CRDT- 2023/10/02 00:33
PHST- 2023/11/22 06:42 [medline]
PHST- 2023/10/02 06:42 [pubmed]
PHST- 2023/10/02 00:33 [entrez]
AID - 00000421-990000000-00132 [pii]
AID - 10.1097/COC.0000000000001047 [doi]
PST - ppublish
SO  - Am J Clin Oncol. 2023 Dec 1;46(12):551-558. doi: 10.1097/COC.0000000000001047. 
      Epub 2023 Oct 2.