Meta-Analysis Of The Efficacy Of EGFR-TKIs In The First-Line Treatment Of Asian EGFR Mutant Advanced Non-Small Cell Lung Cancer

Objective: This study was designed to evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors((EGFR-TKIS)in the first-line treatment of advanced Asian EGFR mutant non-small cell lung cancer using meta-analysis.Methods: The computer searched the Cochrane Library,PubMed,Google Scholar,China Knowledge Network database,Wanfang database and VIP database for five major EGFR-TKIs for randomized controlled trials(RCT)published from January 2010 to February 2019.In order to ensure the homogeneity of the included literature,a strict screening criteria for screening exclusion criteria were developed,and quality evaluation and data extraction were performed,and Meta analysis was performed using Stata software.Results: A total of 7 RCTs were included,totally 1576 patients.Meta-analysis results show that for patients with advanced EGFR-mutant non-small cell lung cancer in Asia,EGFR-TKIs can significantly prolong median progression-free survival(median PFS)compared with platinum-based dual chemotherapy.)(HR = 0.38,95% CI: 0.27 to 0.54,z = 5.45,P = 0.00),the difference was statistically significant.The mesh analysis of each intervention and the calculation of SUCRA values showed that the largest SUCRA was erlotinib,followed by Dacomitinib,and the third was Osimertinib.The worst intervention was platinum-based dual chemotherapy.Conclusion: For first-line treatment of patients with advanced EGFR mutation-positive non-small cell lung cancer in Asia,EGFR-TKIs have better efficacy than standard chemotherapy.Compared with the six interventions,erlotinib was the best,followed by Dacomitinib and Osimertinib,and platinum double chemotherapy was the worst.