@article{JTD14474,
author = {Yaxiong Zhang and Siyu Miao and Fang Wang and Wenfeng Fang and Gang Chen and Xi Chen and Fang Yan and Xiaodan Huang and Manli Wu and Yan Huang and Li Zhang},
title = {The efficacy and toxicity of afatinib in advanced EGFR-positive non-small-cell lung cancer patients after failure of first-generation tyrosine kinase inhibitors: a systematic review and meta-analysis},
journal = {Journal of Thoracic Disease},
volume = {9},
number = {7},
year = {2017},
keywords = {},
abstract = {Background: The first generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), gefitinib and erlotinib, have become the standard first-line treatment for non-small-cell lung cancer (NSCLC) patients with EGFR mutation. However, there was no pooled analysis focused on the usage of the second-generation TKI, afatinib, in advanced EGFR-positive NSCLC patients after failure of first generation TKIs. Therefore, a meta-analysis was conducted to solve the above question.
Methods: Electronic databases were searched for eligible literatures. ORR (objective response rate), DCR (disease controlled rate), PFS (progression-free survival), OS (overall survival) and primary grade 3/4 adverse events were pooled with the corresponding 95% confidence interval using R software. Sensitivity analyses and heterogeneity were quantitatively evaluated.
Results: A total of 545 EGFR-positive patients were available for analysis from five studies after detailed screening from 909 relevant studies. The pooled ORR and DCR of afatinib in EGFR-positive patients after failure of the first generation EGFR-TKIs were 0.12 (0.08–0.19) and 0.60 (0.53–0.68), respectively. Besides, the 6 m-PFS rate, 1 y-PFS rate and 6 m-OS rate were 0.26 (0.22–0.30), 0.08 (0.06–0.10) and 0.74 (0.56–0.86). The grade 3/4 rate of diarrhea and that of skin deformity were 0.23 (0.10–0.46) and 0.14 (0.05–0.33), respectively. Sensitivity analyses revealed similar results with lower heterogeneity.
Conclusions: Considering the efficacy, toxicity and current availability, afatinib could be a therapeutic option for advanced EGFR mutated NSCLC patients after the failure of 1st-generation TKIs.},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/14474}
}