Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Efficacy of EGFR-TKI therapy in patients with brain metastases from non-small-cell lung cancer: A meta-analysis

Wei Zhang^1,2, Lijuan Hu³, Caihong Huang⁴, Jun Ying¹, Naiqing Zhao¹

¹Department of Biostatistics, School of Public Health; ²Fudan University Library, Shanghai; ³Department of Pulmonary Medicine, Research Institute of Respiratory Disease, Zhongshan Hospital, Shanghai, 4Xuhui Central Hospital, Shanghai, China.

For correspondence:- Naiqing Zhao Email: nqzhao@fudan.edu.cn Tel:+862154237485

Accepted: 31 October 2017 Published: 30 November 2017

Citation: Zhang W, Hu L, Huang C, Ying J, Zhao N. Efficacy of EGFR-TKI therapy in patients with brain metastases from non-small-cell lung cancer: A meta-analysis. Trop J Pharm Res 2017; 16(11):2761-2772 doi: 10.4314/tjpr.v16i11.26

© 2017 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: This meta-analysis aimed to systematically evaluate the efficacy of tyrosine kinase inhibitors of epidermal growth factor receptor (EGFR-TKIs) for patients with brain metastases (BM) from non-small-cell lung cancer (NSCLC), and to compare this treatment modality to chemotherapy or radiotherapy.

Methods: PubMed, EMBASE (OvidSP), the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and ASCO Annual Meeting Abstracts were searched. Controlled clinical studies that compared the efficacy of EGFR-TKIs with chemotherapy or radiotherapy for NSCLC patients with BM were included in the analysis. Efficacy indicators included overall survival (OS), local progression-free survival (LPFS) and objective response rate (ORR).

Results: The final sample consisted of 24,637 NSCLC patients with BM from 11 clinical studies. In primary efficacy analysis, it was found that EGFR-TKIs were significantly superior to chemotherapy or radiotherapy in terms of ORR (odds ratio (OR) = 2.10, p = 0.035), OS (hazard ratio (HR) = 0.78, p = 0.011) and LPFS (HR = 0.60, p < 0.001).

Conclusion: Among the patients with BM from NSCLC, EGFR-TKIs exhibit a therapeutic advantage over chemotherapy or radiotherapy, which is reflected in the elevation of ORR and improvement in OS and LPFS

Keywords: Brain metastasis, Non-small-cell lung cancer (NSCLC), Protein kinase Inhibitors, Epidermal growth factor, Meta-analysis