| Objective:Lung cancer is one of the highest morbidity and mortality of malignant tumors in the world.the most common lung cancer are non small cell lung cancer,accounts for80% of lung cancer.When most of the patients with non small cell lung cancer diagnosis is advanced tumors,lost the opportunity to surgery.At present the treatment of lung cancer mainly platinum based chemotherapy is given priority to,but there are many deficiencies,such as: side effects,easy relapse after treatment to relieve,survival time is short.Most patients choose to give up treatment,diagnosis of lung cancer is sentenced to death.It has caused a great burden to society.Therefore for molecular targeted therapy of non-small cell lung cancer brought new hope to patients with EGFR mutations,Targeted treatment have less side effects,the effect is very good,but often appear clinical molecular targeted drugs of primary resistance or use targeted drug treatment 10 to 16 months appear secondary drug resistance phenomenon.In addition to secondary secondary mutations,Studies at home and abroad have shown that BIM gene deletion polymorphism and drug resistance of targeted drugs using In EGFR mutant-positive non-small cell lung cancerare closely related.But no relevant evidence of evidence-based medicine,this study intends to retrieve relevant literature both at home and abroad,Meta analysis method is used to explore that Relationship between BIM deletion polymorphism and the curative effect of EGFR-TKIs in advanced NSCLC patients with EGFR positive mutations.Methods:We searched PubMed?EMbase?The Cochrane Library(Issue 1,2017)?VIP?CBM?CNKI and WangFang Dtabase to collect study about the non-small cell lung cancer Accompanied by BIM polymorphism and EGFR mutations use targeted drug.The duration of search was from the establishment date to January 2017.The literature using the Cochrane collaboration recommended assessment tools to evalu-ate the quality.Date analysis was performed by RevMan5.1?Stata software.Results:10 Studys involving 1381 patients were ultimately identified.The results of metaanalysis showed that,The results of meta-analysis showed that the objective response rate of BIM gene wild type group was higher than that of BIM gene deletion group,the difference was statistically significant[RR=0.42,95%CI(0.26,0.66),P <0.0002];the control rate of BIM gene wild type group was higher than that of BIM gene deletion group,the difference was statistically significant[RR=0.45,95%CI(0.25,0.82),P=0.010];the progression-free survival of BIM gene wild type group was higher than that of BIM gene deletion polymorphism group,the difference was statistically significant [HR=0.72,95%CI(0.54,0.96),P=0.03];the total survival time of BIM gene wild type group was higher than that of BIM gene deletion group,the difference was not statistically significant[HR=1.89,95%CI(1.30,2.74),P=0.0008];there was no significant difference in BIM gene wild type group(rash)and BIM gene deletion polymorphism group[RR=1.27,95%CI(0.63,2.57),P=0.50].There was no significant difference in BIM gene wild type group(RR)and BIM gene deletion polymorphism(RR=1.01,95%CI(0.50,2.06),P=0.97]Conclusion:BIM gene deletion polymorphism was significantly associated with the ORR?DCR?PFS and OS of non-small cell lung cancer with EGFR mutations through the use of targeted drugs?It suggests that BIM gene deletion polymorphism may be the cause of EGFR-TKI resistance to EGFR mutant non-small cell lung cancer patients and can be used as a predictor of clinical efficacy of EGFR-TKI therapy and an independent prognostic factor for EGFR mutations in patients with NSCLC.However,more sample size,more detailed grouping,and multicenter prospective studies should be conducted to validate our results by influencing the quality of the literature and the low number of BIM gene polymorphisms,the Pathologic type,the tumor stage,the subtype of EGFR gene mutation,the smoking status,and the like. |
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