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贝伐珠单抗联合 EGFR-TKIs 治疗晚期非小细胞肺癌的疗效与安全性：Meta 分析。

Efficacy and safety of bevacizumab combined with EGFR-TKIs in advanced non-small cell lung cancer: A meta-analysis.

机构信息

Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, Peoples Republic of China.

Graduate School of Peking Union Medical College, Beijing, Peoples Republic of China.

出版信息

Thorac Cancer. 2022 Jan;13(1):31-37. doi: 10.1111/1759-7714.14214. Epub 2021 Dec 3.

DOI:10.1111/1759-7714.14214
PMID:34859599
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8720617/
Abstract

BACKGROUND

The aim of this study was to estimate the efficacy and safety of bevacizumab combined with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) in advanced non-small cell lung cancer (NSCLC) patients.

METHODS

We searched randomized controlled trials (RCTs) on bevacizumab combined with EGFR TKIs in the NSCLC Cochrane Library, Web of Science, PubMed and Embase. The data were extracted and assessed according to the Cochrane Handbook. We calculated the hazard ratio (HR), risk ratio (RR), and confidence interval (CI), and accomplished this meta-analysis with Stata 14 software.

RESULTS

Of 1301 articles scanned, five articles were involved in this meta-analysis. We determined that compared with using EGFR TKIs alone, combination treatment significantly prolongs progression-free survival (PFS) (HR = 0.61, 95% CI = 0.52-0.70; p < 0.001), and increases the objective response rate (ORR) (RR = 1.15, 95% CI: 1.01-1.30, p = 0.10). However, there was no significant difference in overall survival (OS) between the two groups (HR = 0.95, 95% CI = 0.78-1.11; p = <0.001) and combination treatment increases the risks of serious adverse events (SAEs) (RR = 1.58, 95% CI: 1.21-2.05, p = 0.002).

CONCLUSIONS

Bevacizumab combined with EGFR-TKI significantly improves PFS and ORR in patients with advanced NSCLC, but there is no substantial difference in OS and increase the risks of serious adverse events.

摘要

背景

本研究旨在评估贝伐珠单抗联合表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗晚期非小细胞肺癌（NSCLC）的疗效和安全性。

方法

我们检索了 Cochrane 图书馆、Web of Science、PubMed 和 Embase 中关于贝伐珠单抗联合 EGFR-TKIs 治疗 NSCLC 的随机对照试验（RCT）。根据 Cochrane 手册提取和评估数据。我们使用 Stata 14 软件计算了风险比（HR）、风险比（RR）和置信区间（CI），并进行了这项荟萃分析。

结果

在扫描的 1301 篇文章中，有 5 篇文章纳入了这项荟萃分析。我们发现，与单独使用 EGFR-TKIs 相比，联合治疗显著延长了无进展生存期（PFS）（HR=0.61，95%CI=0.52-0.70；p<0.001），并提高了客观缓解率（ORR）（RR=1.15，95%CI：1.01-1.30，p=0.10）。然而，两组之间的总生存期（OS）没有显著差异（HR=0.95，95%CI=0.78-1.11；p<0.001），联合治疗增加了严重不良事件（SAEs）的风险（RR=1.58，95%CI：1.21-2.05，p=0.002）。

结论

贝伐珠单抗联合 EGFR-TKI 显著改善了晚期 NSCLC 患者的 PFS 和 ORR，但 OS 无明显改善，并增加了严重不良事件的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/ccc5a23625aa/TCA-13-31-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/264d4c830929/TCA-13-31-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/c01f5a00ed78/TCA-13-31-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/c937a60eeb14/TCA-13-31-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/9951f37e9939/TCA-13-31-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/5627c1ea1277/TCA-13-31-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/ccc5a23625aa/TCA-13-31-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/264d4c830929/TCA-13-31-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/c01f5a00ed78/TCA-13-31-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/c937a60eeb14/TCA-13-31-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/9951f37e9939/TCA-13-31-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/5627c1ea1277/TCA-13-31-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e598/8720617/ccc5a23625aa/TCA-13-31-g006.jpg

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