Efficacy And Safety Of EGFR Tyrosine Kinase Inhibitor Monotherapy With Docetaxel Monotherapy In Previously Treated Advanced Non-Small-Cell Lung Cancer: A Meta-analysis

Objective: To systematically evaluate the efficacy and safety of EGFR-TKI monotherapy(gefitinib or erlotinib) with docetaxel monotherapy in non-small-cell lung cancer(NSCLC) experienced disease progression after first-line treatment.Methods:Pub Med,Cochranelibrary,Embase,CNKI,Wan-fang Data and VIP were searched to collect randomized clinical trials(RCTs) comparing EGFR-TKI monotherapy with docetaxel chemotherapy in previously treated advanced NSCLC. The hazard ratio(HR) or odds ratio(OR), with their corresponding 95% confidence intervals(CI) were pooled using Review manager 5.3.0.Results: Six randomized controlled trials involving 2747patients(EGFR-TKI 1389 patients,docetaxel 1358 patients)were eligible. The pooled HRs showed no significant difference in os(HR=0.90,95%CI=0.78 ~ 1.04, Z=1.40, P=0.16). PFS was elongated in docetaxelgroup than in erlotinib group(HR=1.31,95%CI=1.11~1.54,Z=3.24,P=0.001). There was no difference in PFS between docetaxel group and gentitinib group(HR=0.90, 95%CI=0.78 ~1.04, Z=1.40, P=0.16). Safety analysis showed that incidence of side effect at grade 3 or 4 was low in EGFR-TKI group; the side effects included neutropeni(RR=0.06,95% CI=0.04 ~ 0.08),febrile, neutropenia(RR=0.09, 95% CI =0.05 ~ 0.16), and nurotoxicity(RR=0.25, 95% CI =0.05 ~ 0.16). The incidence of rash at grade 3 or 4 was increased(RR=15.03, 95%CI=5.81~38.88).Conclusion: Although having similar OS and PFS, EGFR-TKI is safer and better tolerated.