Overall survival benefits for combining targeted therapy as second-line treatment for advanced non-small-cell-lung cancer: a meta-analysis of published data.
Overall survival benefits for combining targeted therapy as second-line treatment for advanced non-small-cell-lung cancer: a meta-analysis of published data.
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BACKGROUND: Combining targeted therapy has been extensively investigated in previously treated advanced non-small-cell lung cancer color touch 7/97 (NSCLC), but it is still unclear whether combining targeted therapy might offer any benefits against standard monotherapy with erlotinib.We thus performed a meta-analysis of randomized controlled trials to compare the efficacy and safety of combining targeted therapy versus erlotinib alone as second-line treatment for advanced NSCLC.METHODS: Several databases were searched, including Pubmed, Embase and Cochrane databases.The endpoints were overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and grade 3 or 4 adverse event (AEs).
The pooled hazard ratio (HR) or odds ratio (OR), and 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials.RESULTS: Eight eligible trials involved 2417 patients were ultimately identified.The intention to treatment (ITT) analysis demonstrated that combining targeted therapy significantly improved OS (HR 0.90, 95% CI: 0.
82-0.99, p = 0.024), PFS (HR 0.83, 95% CI: 0.
72-0.97, p = 0.018), and ORR (OR 1.35, 95% CI 1.
01-1.80, P = 0.04).Sub-group analysis based on phases of trials, EGFR-status and KRAS status also showed that there was a tendency to improve PFS and OS in combining targeted therapy, except that PFS for patients with EGFR-mutation or wild type KRAS favored erlotinib monotherapy.
Additionally, more incidence of grade 3 or 4 rash, fatigue and hypertension were observed in combining targeted therapy.CONCLUSIONS: With the available evidence, combining targeted therapy seems superior over erlotinib monotherapy as second-line treatment for advanced NSCLC.More studies are still needed to identify patients who will most likely cocktail tree for sale benefit from the appropriate combining targeted therapy.