Chinese General Practice ›› 2022, Vol. 25 ›› Issue (08): 1007-1013.DOI: 10.12114/j.issn.1007-9572.2021.01.413
Special Issue: 肿瘤最新文章合集; 肺癌最新文章合集; 安全用药最新文章合集
• Evidence-based Medicine • Previous Articles Next Articles
Curative Effect of EGFR-TKIs with Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant Non-small Cell Lung Cancer:a Meta-analysis
Department of Thoracic Surgery,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China
* Corresponding author:SU Yanhe,Professor,Chief physician;E-mail:syh1971@sina.com
Received:
2021-12-08
Revised:
2021-12-17
Published:
2022-03-15
Online:
2022-03-02
通讯作者:
苏彦河
CLC Number:
LI Yong, LONG Yong, ZHAO Chong, ZHANG Guanqing, SU Yanhe.
Curative Effect of EGFR-TKIs with Anti-angiogenic Drugs as the Treatment for Patients with Advanced EGFR-mutant Non-small Cell Lung Cancer:a Meta-analysis [J]. Chinese General Practice, 2022, 25(08): 1007-1013.
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2021.01.413
第一作者 | 发表时间(年) | 国家 | 研究类型 | 样本量(T/C) | 疾病分期 | 男性/女性 | 平均年龄(岁) | ||
---|---|---|---|---|---|---|---|---|---|
T | C | T | C | ||||||
YAMAMOTO[ | 2021 | 日本 | RCT | 75/77 | ⅢB-Ⅳ、复发 | 30/45 | 26/51 | 67 | 67 |
STINCHCOMBE[ | 2019 | 美国 | RCT | 43/45 | Ⅳ、复发 | 12/31 | 14/31 | 65 | 63 |
ZHAO[ | 2021 | 中国 | RCT | 157/156 | ⅢB-Ⅳ | 66/91 | 62/94 | 57 | 60 |
SAITO[ | 2019 | 日本 | RCT | 112/112 | ⅢB-Ⅳ、复发 | 41/71 | 39/73 | 67 | 68 |
KATO[ | 2018 | 日本 | RCT | 75/77 | ⅢB-Ⅳ、复发 | 30/45 | 26/51 | 67 | 67 |
KITAGAWA[ | 2019 | 日本 | RCT | 6/10 | Ⅳ、复发 | 1/5 | 3/7 | 74 | 73 |
NAKAGAWA[ | 2019 | 日本 | RCT | 224/225 | Ⅳ、复发 | 83/141 | 83/142 | 65 | 64 |
SETO[ | 2014 | 日本 | RCT | 75/77 | ⅢB-Ⅳ、复发 | 30/45 | 26/51 | 67 | 67 |
ZHOU[ | 2019 | 中国 | RCT | 157/154 | ⅢB-Ⅳ、复发 | 60/97 | 58/96 | 57 | 59 |
Table 1 Basic characteristics of the included randomized controlled trials
第一作者 | 发表时间(年) | 国家 | 研究类型 | 样本量(T/C) | 疾病分期 | 男性/女性 | 平均年龄(岁) | ||
---|---|---|---|---|---|---|---|---|---|
T | C | T | C | ||||||
YAMAMOTO[ | 2021 | 日本 | RCT | 75/77 | ⅢB-Ⅳ、复发 | 30/45 | 26/51 | 67 | 67 |
STINCHCOMBE[ | 2019 | 美国 | RCT | 43/45 | Ⅳ、复发 | 12/31 | 14/31 | 65 | 63 |
ZHAO[ | 2021 | 中国 | RCT | 157/156 | ⅢB-Ⅳ | 66/91 | 62/94 | 57 | 60 |
SAITO[ | 2019 | 日本 | RCT | 112/112 | ⅢB-Ⅳ、复发 | 41/71 | 39/73 | 67 | 68 |
KATO[ | 2018 | 日本 | RCT | 75/77 | ⅢB-Ⅳ、复发 | 30/45 | 26/51 | 67 | 67 |
KITAGAWA[ | 2019 | 日本 | RCT | 6/10 | Ⅳ、复发 | 1/5 | 3/7 | 74 | 73 |
NAKAGAWA[ | 2019 | 日本 | RCT | 224/225 | Ⅳ、复发 | 83/141 | 83/142 | 65 | 64 |
SETO[ | 2014 | 日本 | RCT | 75/77 | ⅢB-Ⅳ、复发 | 30/45 | 26/51 | 67 | 67 |
ZHOU[ | 2019 | 中国 | RCT | 157/154 | ⅢB-Ⅳ、复发 | 60/97 | 58/96 | 57 | 59 |
亚组分析 | 文献数(篇) | 异质性 | Meta分析结果 | |||
---|---|---|---|---|---|---|
I2(%) | P值 | HR(95%CI) | P值 | |||
年龄(岁) | ≥65 | 2 | 0 | 0.672 | 0.80(0.59,1.08) | 0.141 |
<65 | 2 | 0 | 0.351 | 0.59(0.46,0.76) | <0.001 | |
性别 | 男 | 3 | 38.4 | 0.197 | 0.54(0.41,0.70) | <0.001 |
女 | 3 | 0 | 0.995 | 0.72(0.58,0.89) | 0.003 | |
基因突变位点 | 19del | 5 | 0 | 0.572 | 0.63(0.52,0.76) | <0.001 |
L858R | 5 | 0 | 0.777 | 0.63(0.53,0.75) | <0.001 | |
疾病分期 | ⅢB | 2 | 57 | 0.127 | 0.64(0.10,4.10) | 0.639 |
Ⅳ | 3 | 0 | 0.763 | 0.66(0.56,0.78) | <0.001 | |
复发 | 3 | 27.3 | 0.253 | 0.49(0.29,0.84) | 0.009 | |
ECOG评分 | 0 | 3 | 0 | 0.534 | 0.62(0.48,0.80) | <0.001 |
1 | 3 | 0 | 0.974 | 0.66(0.53,0.82) | <0.001 | |
吸烟 | 是 | 3 | 26.4 | 0.257 | 0.57(0.41,0.79) | 0.001 |
否 | 4 | 0 | 0.792 | 0.67(0.55,0.81) | <0.001 | |
脑转移 | 是 | 3 | 57.8 | 0.093 | 0.65(0.39,1.06) | 0.086 |
否 | 3 | 0 | 0.879 | 0.62(0.50,0.77) | <0.001 | |
肝转移 | 是 | 2 | 0 | 0.837 | 0.46(0.23,0.84) | <0.001 |
否 | 2 | 0 | 0.769 | 0.67(0.55,0.81) | <0.001 | |
胸腔积液 | 是 | 2 | 0 | 0.722 | 0.63(0.44,0.89) | 0.009 |
否 | 2 | 0 | 0.824 | 0.70(0.51,0.96) | 0.024 |
Table 2 Subgroup analysis of progression-free survival between combination therapy group and monotherapy group
亚组分析 | 文献数(篇) | 异质性 | Meta分析结果 | |||
---|---|---|---|---|---|---|
I2(%) | P值 | HR(95%CI) | P值 | |||
年龄(岁) | ≥65 | 2 | 0 | 0.672 | 0.80(0.59,1.08) | 0.141 |
<65 | 2 | 0 | 0.351 | 0.59(0.46,0.76) | <0.001 | |
性别 | 男 | 3 | 38.4 | 0.197 | 0.54(0.41,0.70) | <0.001 |
女 | 3 | 0 | 0.995 | 0.72(0.58,0.89) | 0.003 | |
基因突变位点 | 19del | 5 | 0 | 0.572 | 0.63(0.52,0.76) | <0.001 |
L858R | 5 | 0 | 0.777 | 0.63(0.53,0.75) | <0.001 | |
疾病分期 | ⅢB | 2 | 57 | 0.127 | 0.64(0.10,4.10) | 0.639 |
Ⅳ | 3 | 0 | 0.763 | 0.66(0.56,0.78) | <0.001 | |
复发 | 3 | 27.3 | 0.253 | 0.49(0.29,0.84) | 0.009 | |
ECOG评分 | 0 | 3 | 0 | 0.534 | 0.62(0.48,0.80) | <0.001 |
1 | 3 | 0 | 0.974 | 0.66(0.53,0.82) | <0.001 | |
吸烟 | 是 | 3 | 26.4 | 0.257 | 0.57(0.41,0.79) | 0.001 |
否 | 4 | 0 | 0.792 | 0.67(0.55,0.81) | <0.001 | |
脑转移 | 是 | 3 | 57.8 | 0.093 | 0.65(0.39,1.06) | 0.086 |
否 | 3 | 0 | 0.879 | 0.62(0.50,0.77) | <0.001 | |
肝转移 | 是 | 2 | 0 | 0.837 | 0.46(0.23,0.84) | <0.001 |
否 | 2 | 0 | 0.769 | 0.67(0.55,0.81) | <0.001 | |
胸腔积液 | 是 | 2 | 0 | 0.722 | 0.63(0.44,0.89) | 0.009 |
否 | 2 | 0 | 0.824 | 0.70(0.51,0.96) | 0.024 |
AE | 文献数(篇) | 发生不良事件人数/总人数 | 异质性 | Meta分析结果 | |||
---|---|---|---|---|---|---|---|
T | C | I2(%) | P值 | RR(95%CI) | P值 | ||
高血压 | 6 | 216/614 | 35/623 | 73.4 | 0.002 | 6.15(2.90,13.03) | <0.001 |
腹泻 | 5 | 42/608 | 14/615 | 50.1 | 0.091 | 2.75(1.07,7.06) | 0.033 |
蛋白尿 | 5 | 53/608 | 2/615 | 0 | 0.943 | 15.69(5.35,460.02) | <0.001 |
出血 | 4 | 9/565 | 5/570 | 0 | 0.548 | 1.69(0.62,4.62) | 0.308 |
皮疹 | 6 | 60/614 | 53/625 | 5.1 | 0.384 | 1.17(0.84,1.63) | 0.368 |
食欲减退 | 3 | 12/490 | 5/493 | 0 | 0.538 | 2.29(0.85,6.22) | 0.103 |
白细胞降低 | 3 | 19/344 | 2/345 | 69.4 | 0.038 | 2.45(0.12,50.89) | 0.521 |
转氨酶升高 | 3 | 39/384 | 36/389 | 0 | 0.998 | 1.12(0.73,1.72) | 0.603 |
Table 3 Incidence of adverse events above grade 3 in advanced EGFR-mutant NSCLC patients
AE | 文献数(篇) | 发生不良事件人数/总人数 | 异质性 | Meta分析结果 | |||
---|---|---|---|---|---|---|---|
T | C | I2(%) | P值 | RR(95%CI) | P值 | ||
高血压 | 6 | 216/614 | 35/623 | 73.4 | 0.002 | 6.15(2.90,13.03) | <0.001 |
腹泻 | 5 | 42/608 | 14/615 | 50.1 | 0.091 | 2.75(1.07,7.06) | 0.033 |
蛋白尿 | 5 | 53/608 | 2/615 | 0 | 0.943 | 15.69(5.35,460.02) | <0.001 |
出血 | 4 | 9/565 | 5/570 | 0 | 0.548 | 1.69(0.62,4.62) | 0.308 |
皮疹 | 6 | 60/614 | 53/625 | 5.1 | 0.384 | 1.17(0.84,1.63) | 0.368 |
食欲减退 | 3 | 12/490 | 5/493 | 0 | 0.538 | 2.29(0.85,6.22) | 0.103 |
白细胞降低 | 3 | 19/344 | 2/345 | 69.4 | 0.038 | 2.45(0.12,50.89) | 0.521 |
转氨酶升高 | 3 | 39/384 | 36/389 | 0 | 0.998 | 1.12(0.73,1.72) | 0.603 |
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