Jin Hui, Liang Ping, Hou Juan, Li Bin, Wang Ping, He Xin
Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
Department of Pharmacy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
J Oncol. 2023 Mar 2;2023:5493725. doi: 10.1155/2023/5493725. eCollection 2023.
The aim of this study is to evaluate the efficacy and safety of afatinib in the treatment of non-small cell lung cancer (NSCLC) patients with brain metastasis based on meta-analysis.
Related literatures were searched in the following databases: EMbase, PubMed, China Knowledge Network (CNKI), Wanfang, Weipu, Google Scholar, the China Biomedical Literature Service System, and other databases. Clinical trials and observational studies that met the requirements were selected for meta-analysis using Revman 5.3. The hazard ratio (HR) was used as an indicator of the impact of afatinib.
A total of 142 related literatures were acquired, but after screening, five literatures were selected for data extraction. The following indices were compared: the progression-free survival (PFS), overall survival (OS), and common adverse reactions (ARs) of grade 3 and above. A total of 448 patients with brain metastases were included and were divided into two groups: the control group (no afatinib treatment, with chemotherapy alone and the first-generation EGFR-TKIs) and the afatinib group. The results showed that afatinib could improve PFS (HR: 0.58, 95% CI: 0.39-0.85, < 0.05) and ORR (OR = 2.86, 95% CI: 1.45-2.57, < 0.05), but had no benefit on OS (HR: 1.13, 95% CI: 0.15-8.75, > 0.05) and DCR (OR = 2.87, 95% CI: 0.97-8.48, > 0.05). For the safety of afatinib, the incidence of grade-3-and-above ARs was low (HR: 0.01, 95% CI: 0.00-0.02, < 0.05).
Afatinib improves the survival of NSCLC patients with brain metastases and shows satisfactory safety.
本研究旨在基于荟萃分析评估阿法替尼治疗非小细胞肺癌（NSCLC）脑转移患者的疗效和安全性。
在以下数据库中检索相关文献：EMbase、PubMed、中国知网（CNKI）、万方、维普、谷歌学术、中国生物医学文献服务系统及其他数据库。使用Revman 5.3软件对符合要求的临床试验和观察性研究进行荟萃分析。采用风险比（HR）作为阿法替尼疗效的评估指标。
共获取142篇相关文献，经筛选后选取5篇文献进行数据提取。比较了以下指标：无进展生存期（PFS）、总生存期（OS）以及3级及以上的常见不良反应（ARs）。共纳入448例脑转移患者，分为两组：对照组（未接受阿法替尼治疗，仅接受化疗和第一代表皮生长因子受体酪氨酸激酶抑制剂[EGFR-TKIs]）和阿法替尼组。结果显示，阿法替尼可改善PFS（HR：0.58，95%可信区间[CI]：0.39 - 0.85，P < 0.05）和客观缓解率（OR = 2.86，95% CI：1.45 - 2.57，P < 0.05），但对OS（HR：1.13，95% CI：0.15 - 8.75，P > 0.05）和疾病控制率（DCR，OR = 2.87，95% CI：0.97 - 8.48，P > 0.05）无显著影响。关于阿法替尼的安全性，3级及以上ARs的发生率较低（HR：0.01，95% CI：0.00 - 0.02，P < 0.05）。
阿法替尼可改善NSCLC脑转移患者的生存期，且安全性良好。
