European Journal of Medical Research | |
Bevacizumab plus erlotinib versus erlotinib alone for advanced EGFR-mutant non-small cell lung cancer: a meta-analysis of randomized clinical trials | |
Research | |
Fang Zhang1  Shanshan Li1  Ruijian Li1  Weiyi Li2  | |
[1] Department of Radiation Oncology, Yantai Affiliated Hospital of Binzhou Medical University, No 717, Jinbu Road, 264000, Yantai, Shandong, China;Department of Respiratory, Yantai Affiliated Hospital of Binzhou Medical University, 264000, Yantai, China; | |
关键词: Bevacizumab; Erlotinib; Non-small cell lung cancer; Subgroup; Meta-analysis; | |
DOI : 10.1186/s40001-023-01272-7 | |
received in 2022-11-20, accepted in 2023-08-07, 发布年份 2023 | |
来源: Springer | |
【 摘 要 】
ObjectivePrevious studies showed that the combination of bevacizumab and erlotinib (combination therapy) significantly prolonged progression-free survival (PFS) but no overall survival (OS) compared to erlotinib alone (monotherapy) for advanced EGFR-mutant non-small cell lung cancer (NSCLC). Two phase III randomized controlled trials (RCTs) had reported the OS results in 2021. This meta-analysis aimed to include the results of the two RCTs to make a decision.Materials and methodsWe systematically searched relevant databases for RCTs on the use of bevacizumab plus erlotinib in advanced EGFR-mutant NSCLC. The main outcomes of interest were PFS, OS, and the reported hazard ratio (HR). Fixed-effect model was used to estimate pooled HR.ResultsTotal 5 RCTs with 935 patients were eligible for this meta-analysis. All studies reached their primary study endpoints including PFS and OS. Compared to monotherapy, combination therapy remarkably prolonged PFS (HR = 0.60, 95% confidence interval CI 0.51–0.70; p < 0.00001); however, OS was similar between the two groups (HR = 0.90, 95% CI 0.76–1.08; p = 0.26). Subgroup analysis demonstrated that in deletion within exon 19 (19del) mutation subgroup, the combination therapy could only prolong PFS (HR = 0.60, 95% CI 0.47–0.76; p < 0.0001) but not OS (HR = 1.00, 95% CI 0.73–1.37; p = 1.00), and also in leucine-to-arginine substitution in exon 21 (L858R) mutation subgroup (HR = 0.59, p < 0.0001 and HR = 0.80, p = 0.18, respectively). For patients with brain metastasis at baseline, the combination therapy achieved a significant better PFS than the monotherapy (HR = 0.60, 95% CI 0.39–0.90; p = 0.01), and a better OS with the difference marginally significant (HR = 0.69, 95% CI 0.46–1.02; p = 0.06).ConclusionsCombination of bevacizumab and erlotinib can prolong progression-free survival but not overall survival compared to erlotinib alone in advanced EGFR-mutant non-small cell lung cancer patients. The combination therapy not only can prolong progression-free survival but also has a tendency to prolong overall survival for patients with brain metastasis at baseline.
【 授权许可】
CC BY
© BioMed Central Ltd., part of Springer Nature 2023
【 预 览 】
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RO202309158668887ZK.pdf | 2263KB | download | |
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Fig. 3 | 1103KB | Image | download |
MediaObjects/12888_2023_5016_MOESM2_ESM.docx | 14KB | Other | download |
MediaObjects/12888_2023_5016_MOESM4_ESM.docx | 81KB | Other | download |
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Fig. 3
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