Guo Jiwu, Ma Bin, Zhou Huiyin, Wang Yao, Zhang Yuan
Evidence-Based Medicine Center of Lanzhou University, School of Basic Medical Science, Lanzhou University, Lanzhou, China.
Zhongguo Fei Ai Za Zhi. 2011 Apr;14(4):351-7. doi: 10.3779/j.issn.1009-3419.2011.04.09.
Malignant grade and death rate are very high for non-small cell lung cancer, and gefitinib is a new molecule target anticancer drug. The aim of this meta analysis is to evaluate the clinical efficacy and safety of gefitinib for non-small cell lung cancer.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 8, 2010), PubMed (1966-2010.8), EMBASE (1974-2010.8), CNKI (1994-2010.8), VIP (1989-2010.8), and CMD Digital Periodicals (1998-2010.8). Two reviewers independently evaluated the quality of the included studies and extracted the data. Meta-analyses were performed by RevMan 5.0 software.
Thirteen randomized controlled trials (RCTs) involving 6,207 patients were included. The results of meta-analyses showed that: gefitinib showed no remarkable advantage in media survival time, 1 year survival rate, complete response rate (CRR), partial response rate (PRR), stable disease (SD) when compared to Placebo, Docetaxel, Cisplatin+Docetaxel, Pemetrexed. Gifitinib could increase overall survival rate compared to Docetaxel, Cisplatin+Docetaxel (RR=1.41, 95%CI: 1.10-1.80; RR=1.93, 95%: 1.26-2.94). When compared to Placebo, Docetaxel, gifitinib could improve life quality of Total-FACT-L improve rate (RR=1.42, 95%CI: 1.16-1.74; RR=1.66, 95%CI: 1.39-1.97). The major adverse event for gifitinib were rash/acne, dry skin, diarrhea. While gifitinib showed lower hematology toxicity.
Gifitinib shows more superiority for non-small cell lung cancer, and its clinical application is worthy to be advocated.
非小细胞肺癌恶性程度及死亡率很高,吉非替尼是一种新型分子靶向抗癌药物。本荟萃分析的目的是评估吉非替尼治疗非小细胞肺癌的临床疗效和安全性。
我们检索了Cochrane系统评价数据库(CENTRAL)(Cochrane图书馆,2010年第8期)、PubMed(1966 - 2010.8)、EMBASE(1974 - 2010.8)、中国知网(1994 - 2010.8)、维普资讯(1989 - 2010.8)和中国生物医学文献数据库(1998 - 2010.8)。两名评价者独立评估纳入研究的质量并提取数据。采用RevMan 5.0软件进行荟萃分析。
纳入13项随机对照试验(RCT),涉及6207例患者。荟萃分析结果显示:与安慰剂、多西他赛、顺铂 + 多西他赛、培美曲塞相比,吉非替尼在中位生存时间、1年生存率、完全缓解率(CRR)、部分缓解率(PRR)、疾病稳定(SD)方面无显著优势。与多西他赛、顺铂 + 多西他赛相比,吉非替尼可提高总生存率(RR = 1.41,95%CI:1.10 - 1.80;RR = 1.93,95%CI:1.26 - 2.94)。与安慰剂、多西他赛相比,吉非替尼可提高生活质量总FACT - L改善率(RR = 1.42,95%CI:1.16 - 1.74;RR = 1.66,95%CI:1.39 - 1.97)。吉非替尼的主要不良事件为皮疹/痤疮、皮肤干燥、腹泻。而吉非替尼血液学毒性较低。
吉非替尼治疗非小细胞肺癌显示出更多优势,其临床应用值得提倡。