EGFR-TKIs Contrasted With Chemotherapy As First-line Treatment For Advanced Non-small Cell Lung Cancer: A Meta Analysis

Objective To evaluate the efficacy and safety of EGFR-TKIs contrasted withchemotherapy as first-line treatment for advanced NSCLC by meta analysis.Method Relevant literatures were searched through authoritative databases andrelated meetings. All the clinic trials were RCTs, relevant with EGFR-TKIs versuschemotherapy as first-line treatment for advanced NSCLC. All literatures wereassessed by the inclusion and exclusion criteria, quality assessment and dataabstraction. The meta analysis was performed by RevMan5.0software. The stabilityand reliability were evaluated by sensitivity analysis and publication bias analysis.Results Nine literatures from a total of eight prospective, phase III, randomizedcontrolled trials(RCTs) were included into the meta analysis. Among all the2971advanced NSCLC patients, there were1702patients with EGFR mutations. In theadvanced NSCLC patients with EGFR mutations, this meta analysis showed astatistical significance in ORR(RR=2.16，95%CI：[1.72，2.71]，P＜0.00001) andPFS(HR=0.36，95%CI：[0.22，0.60]， P＜0.0001) for patients who receivedEGFR-TKIs compared with patients who received chemotherapy. No statisticalsignificance was observed in OS(HR=1.00，95%CI：[0.85，1.17]， P=1.00).EGFR-TKIs therapy compared with chemotherapy, reduced the ratio of severe sideeffects(OR=0.34，95%CI：[0.20，0.57]，P＜0.0001). Rash(OR=8.47，95%CI：[4.41，16.26]，P＜0.00001), diarrhea(OR=5.60，95%CI：[2.91，10.75]，P＜0.00001) andstomatitis(OR=7.03，95%CI：[2.09，23.67]，P=0.002) EGFR-TKIs therapy hadstatistical significance compared with chemotherapy.Conclusion In advanced NSCLC patients with EGFR mutations, EGFR-TKIs asfirst-line treatment improved ORR and PFS. Main severe side effects were rash, diarrhea and stomatitis.