Liu Lian, Zhang Yue, Wei Jia, Chen Zhaoxin, Yu Jing
Cancer Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China.
J Cancer. 2019 Jan 30;10(4):799-809. doi: 10.7150/jca.29643. eCollection 2019.
: To estimate the efficacy and safety of vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) in combination with chemotherapy for patients with advanced non-small cell lung cancer (NSCLC). : We searched PubMed, PMC database, EMBASE, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), American Society of Clinical Oncology (ASCO), International Association for the Study of Lung Cancer (IASLC) and the European Society of Medical Oncology (ESMO), http://www.clinicaltrials.gov/, CNKI, and Wanfang databases to identify primary research reporting the survival outcomes and safety of VEGFR-TKIs in patients with advanced NSCLC. A meta-analysis was conducted to generate combined hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and risk ratios (RRs) with 95% CI for adverse events (AEs). : A total of 20 RCTs (8,366 participants) were included. The VEGFR-TKIs resulted in improved PFS (HR 0.82, 95% CI 0.78-0.87), ORR (HR 1.72, 95% CI 1.34-2.22), and DCR (1.45, 1.26-1.67) in patients with advanced NSCLC, but had no impact on OS (HR 0.94, 95% CI 0.89-1.00). The incidence of some high grade (≥ 3) AEs increased, such as hemorrhage, hypertension and neutropenia. : Our study demonstrated that regimens with VEGFR-TKIs combined with chemotherapy improved PFS, ORR and DCR in patients with advanced NSCLC, but had no impact on OS. VEGFR-TKIs induced more frequent and serious AEs compared with control therapies.
评估血管内皮生长因子受体酪氨酸激酶抑制剂（VEGFR-TKIs）联合化疗治疗晚期非小细胞肺癌（NSCLC）患者的疗效和安全性。我们检索了PubMed、PMC数据库、EMBASE、EBSCO-Medline、Cochrane对照试验中央注册库（CENTRAL）、美国临床肿瘤学会（ASCO）、国际肺癌研究协会（IASLC）和欧洲医学肿瘤学会（ESMO）、http://www.clinicaltrials.gov/、中国知网和万方数据库，以确定报告VEGFR-TKIs治疗晚期NSCLC患者生存结局和安全性的原始研究。进行荟萃分析以生成总生存（OS）、无进展生存（PFS）、客观缓解率（ORR）、疾病控制率（DCR）的合并风险比（HRs）及95%置信区间（CI），以及不良事件（AEs）的风险比（RRs）及95%CI。共纳入20项随机对照试验（8366名参与者）。VEGFR-TKIs可改善晚期NSCLC患者的PFS（HR 0.82，95%CI 0.78 - 0.87）、ORR（HR 1.72，95%CI 1.34 - 2.22）和DCR（1.45，1.26 - 1.67），但对OS无影响（HR 0.94，95%CI 0.89 - 1.00）。一些高级别（≥3级）AE的发生率增加，如出血、高血压和中性粒细胞减少。我们的研究表明，VEGFR-TKIs联合化疗方案可改善晚期NSCLC患者的PFS、ORR和DCR，但对OS无影响。与对照治疗相比，VEGFR-TKIs导致更频繁和严重的AE。
