Efficacy Of Maintenance Therapy For Advanced NSCLC With EGFR-TKI Regimens: A Meta Analysis

Objective To evaluate the clinical efficacy of maintenance therapy withEGFR-TKI Regimen in advanced NSCLC patients by meta analysis.Method Search all the RCTs potentially relevant with NSCLCmaintenance treatment with EGFR-TKI regimen from authoritativedatabases. After inclusion and data abstraction perform meta-analysiswith Revman5.0.Results Nine tirals of2608patients were included in this anlysis.EGFR-TKI maintenance therapy improved PFS substantially HR=0.67，95%CI0.62-0.74，with no evidence of heterogeneity P=.31,I2=16%；OSwas improved either，HR0.85，95%CI0.79-0.91，with no evidence ofheterogeneity P=.40,I2=1；OS of gefitinib group was improved HR=0.83，95%CI0.74-0.92(P=.31,I2=15%)，OS of erlotinib group was improvedHR=0.87，95%CI0.78-0.96(P=.26,I2=23%)， with no evidence ofheterogeneity。EGFR-TKI maintenance therapy also improves1yearsurvival， RR=1.23，95%CI1.02-1.49although has heterogeneityP<0.00001,I2=86%.EGFR-TKI maintenance therapy can not improve2year survival. In subgroup of adenocarcinoma had superiority of HRcompared with non-adenocarcinoma subgroup， HR and95%CIs were (HR=0.78,95%CI0.68-0.91)，(HR=0.95,95%CI0.78-1.17)，respectively.And subgroup of clinical stage Ⅳ had superiority of HR compared withstage IIIB, HR and95%CIs were （HR=0.84，95%CI0.70-0.94），（HR=0.90，95%CI0.73-1.12）。Rash（OR=27.10，95%CI6.52-112.61）and diarrea（OR=8.69，95%CI2.04-39.36）of EGFR-TKI maintenancetherapy had statistical difference compared with controlled group.Conclusion EGFR-TKI maintenance therapy of NSCLC patientsnon-progressing after first-line chemotherapy impvorves PFS and OS.Especially to patients with adenocarcinoma or at clinical stage ofⅣ.Main toxicity was rash and dirrea.