PMID- 37873790
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231027
IS  - 2079-9721 (Print)
IS  - 2079-9721 (Electronic)
IS  - 2079-9721 (Linking)
VI  - 11
IP  - 4
DP  - 2023 Oct 23
TI  - Comparing Efficacy of Erlotinib and Bevacizumab Combination with Erlotinib 
      Monotherapy in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC): A 
      Systematic Review and Meta-Analysis.
LID - 10.3390/diseases11040146 [doi]
LID - 146
AB  - The objective of this systematic review and meta-analysis was to assess and 
      contrast the efficacy and safety of combining erlotinib and bevacizumab with 
      erlotinib alone in the treatment of patients with advanced non-small cell lung 
      cancer (NSCLC). The authors searched databases such as PubMed, Medline, Scopus, 
      and Cochrane Central Register of Controlled Trials for randomized control trials 
      (RCTs) comparing erlotinib plus bevacizumab with erlotinib in NSCLC patients. The 
      overall survival (OS), progression-free survival (PFS), objective response rate 
      (ORR), and adverse events (AEs) were the outcomes of interest. The pooled hazard 
      ratio (HR) and relative risk (RR) were estimated utilizing both fixed- and 
      random-effect models. Methodological quality of the included studies was assessed 
      using the Cochrane Risk of Bias tool. Nine studies comprising 1698 patients with 
      NSCLC were included in this meta-analysis, of whom 850 were treated with 
      erlotinib plus bevacizumab, and 848 with erlotinib. The erlotinib plus 
      bevacizumab combination significantly prolonged PFS (HR, 0.62, 95% CI: 0.56, 
      0.70, p < 0.00001) but did not show any significant improvement in OS (HR, 0.95; 
      95% CI: 0.83, 1.07, p = 0.39) and ORR (HR, 1.10; 95% CI: 0.98, 1.24, p = 0.09). 
      Increased risks of hypertension (RR, 5.15; 95% CI: 3.59, 7.39; p < 0.00001), 
      proteinuria (RR, 10.54; 95% CI: 3.80, 29.20; p < 0.00001) and grade 3 and higher 
      AEs (RR, 2.09; 95% CI: 1.47, 2.97; p < 0.00001) were observed with the 
      erlotinib-plus-bevacizumab combination compared to erlotinib monotherapy. On 
      subgroup analyses, the erlotinib plus bevacizumab combination improved PFS only. 
      Combining erlotinib and bevacizumab has been shown to improve PFS in advanced 
      NSCLC patients but did not show any significant OS and ORR benefits. Furthermore, 
      risks of hypertension, proteinuria, and grade 3 or higher AEs were greater with 
      the erlotinib-and-bevacizumab combination.
FAU - Sakharkar, Prashant
AU  - Sakharkar P
AD  - Department of Clinical and Administrative Sciences, College of Science, Health 
      and Pharmacy, Roosevelt University, Schaumburg, IL 60173, USA.
FAU - Kurup, Sonali
AU  - Kurup S
AD  - Department of Pharmaceutical Sciences, College of Pharmacy, Ferris State 
      University, Big Rapids, MI 49307, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231023
PL  - Switzerland
TA  - Diseases
JT  - Diseases (Basel, Switzerland)
JID - 101636232
PMC - PMC10594499
OTO - NOTNLM
OT  - EGFR-TKI
OT  - NSCLC
OT  - VEGFR-TKI
OT  - bevacizumab
OT  - epidermal growth factor receptor tyrosine kinase inhibitor
OT  - erlotinib
OT  - non-small cell lung cancer
OT  - vascular endothelial growth factor receptor tyrosine kinase inhibitor
COIS- The authors declare no conflict of interest.
EDAT- 2023/10/24 12:42
MHDA- 2023/10/24 12:43
PMCR- 2023/10/23
CRDT- 2023/10/24 06:35
PHST- 2023/06/17 00:00 [received]
PHST- 2023/09/24 00:00 [revised]
PHST- 2023/10/19 00:00 [accepted]
PHST- 2023/10/24 12:43 [medline]
PHST- 2023/10/24 12:42 [pubmed]
PHST- 2023/10/24 06:35 [entrez]
PHST- 2023/10/23 00:00 [pmc-release]
AID - diseases11040146 [pii]
AID - diseases-11-00146 [pii]
AID - 10.3390/diseases11040146 [doi]
PST - epublish
SO  - Diseases. 2023 Oct 23;11(4):146. doi: 10.3390/diseases11040146.