Qi Wei-Xiang, Sun Yuan-Jue, Shen Zan, Yao Yang
J Chemother. 2015 Feb;27(1):40-51. doi: 10.1179/1973947814Y.0000000189. Epub 2014 Apr 14.
To assess the risk of interstitial lung disease (ILD) with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) gefitinib, erlotinib, and afatinib.
PubMed databases were searched for relevant articles. Statistical analyses were conducted to calculate the summary incidence, odds ratio (OR), and 95% confidence intervals (CIs) by using either random-effects or fixed-effect models.
The incidence of all-grade and high-grade (≧ grade 3) ILD associated with EGFR-TKIs was 1.6% (95% CI, 1.0-2.4%) and 0.9% (95% CI, 0.6%-1.4%), with a mortality of 13.0% (95% CI, 7.6-21.6%). Patients treated with EGFR-TKIs had a significantly increased risk of developing all-grade (OR, 1.74; 95% CI, 1.25-2.43; P = 0.001) and high-grade (OR, 4.38; 95% CI, 2.18-8.79; P<0.001) ILD. No significant difference in the risk of ILD was found in sub-group analysis according to EGFR-TKIs, percentage of EGFR mutation, study location, EGFR-TKIs-based regimens, and controlled therapy.
Treatment with EGFR-TKIs is associated with a significantly increased risk of developing ILD.
评估表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）吉非替尼、厄洛替尼和阿法替尼引发间质性肺病（ILD）的风险。
检索PubMed数据库中的相关文章。采用随机效应或固定效应模型进行统计分析，以计算汇总发病率、比值比（OR）和95%置信区间（CIs）。
与EGFR-TKIs相关的所有级别和高级别（≥3级）ILD的发病率分别为1.6%（95%CI，1.0 - 2.4%）和0.9%（95%CI，0.6% - 1.4%），死亡率为13.0%（95%CI，7.6 - 21.6%）。接受EGFR-TKIs治疗的患者发生所有级别（OR，1.74；95%CI，1.25 - 2.43；P = 0.001）和高级别（OR，4.38；95%CI，2.18 - 8.79；P < 0.001）ILD的风险显著增加。根据EGFR-TKIs、EGFR突变百分比、研究地点、基于EGFR-TKIs的治疗方案和对照治疗进行亚组分析时，未发现ILD风险存在显著差异。
EGFR-TKIs治疗与发生ILD的风险显著增加相关。
