An Zeqi, He Libin, Chen Tuo, Liang Bosen, Wu Qiang
Department of Otorhinolaryngology Head and Neck Surgery Shenzhen University General Hospital Shenzhen China.
Laryngoscope Investig Otolaryngol. 2024 May 27;9(3):e1279. doi: 10.1002/lio2.1279. eCollection 2024 Jun.
EGFR-tyrosine kinase inhibitor (TKI) is used to treat recurrent and metastatic nasopharyngeal carcinoma (rmNPC). This meta-analysis aims to study the efficacy and safety of EGFR-TKI in treating patients with rmNPC.
We conducted a systematic search of PubMed, Embase, and Web of Science up to November 2023, and included literature that met the criteria. We extracted objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and adverse reaction-related events and performed meta-analysis using Stata 14.0.
A total of nine articles were included. The summary results showed that the ORR for patients treated with EGFR-TKI for rmNPC was 38% (95% CI = 27%-49%), the DCR was 71% (95% CI = 61%-80%), the mPFS was 6.29 months (95% CI = 5.22-7.35), and the mOS was 15.94 months (95% CI = 14.68-17.20). The most common grade 3-4 adverse reaction events in these patients were mucositis, nasopharyngeal necrosis, and oral ulceration. We found an incidence rate of 49% (95% CI = 38%-61%) for grade 3-4 adverse events (AEs). The anti-PD1 combined with TKI treatment method is more effective than the EGFR-TKI alone for treating rmNPC.
The study shows that EGFR-TKI has good efficacy in treating rmNPC but does not translate into survival benefits and owns a high incidence of grade 3-4 AEs. More RCT trials are needed in the future to verify the efficacy of anti-PD1 combined with TKI treatment method.
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）用于治疗复发和转移性鼻咽癌（rmNPC）。本荟萃分析旨在研究EGFR-TKI治疗rmNPC患者的疗效和安全性。
截至2023年11月，我们对PubMed、Embase和Web of Science进行了系统检索，并纳入符合标准的文献。我们提取客观缓解率（ORR）、疾病控制率（DCR）、中位无进展生存期（mPFS）、中位总生存期（mOS）以及不良反应相关事件，并使用Stata 14.0进行荟萃分析。
共纳入9篇文章。汇总结果显示，EGFR-TKI治疗rmNPC患者的ORR为38%（95%CI=27%-49%），DCR为71%（95%CI=61%-80%），mPFS为6.29个月（95%CI=5.22-7.35），mOS为15.94个月（95%CI=14.68-17.20）。这些患者中最常见的3-4级不良反应事件为黏膜炎、鼻咽坏死和口腔溃疡。我们发现3-4级不良事件（AE）的发生率为49%（95%CI=38%-61%）。抗PD1联合TKI治疗方法在治疗rmNPC方面比单独使用EGFR-TKI更有效。
该研究表明，EGFR-TKI在治疗rmNPC方面具有良好疗效，但未转化为生存获益，且3-4级AE的发生率较高。未来需要更多随机对照试验来验证抗PD1联合TKI治疗方法的疗效。
