Erlotinib-based doublet targeted therapy versus erlotinib alone in previously treated advanced non-small-cell lung cancer: a meta-analysis from 24 randomized controlled trials
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Jian-Wei Gao1,*, Ping Zhan1,*, Xiang-Yu Qiu2, Jia-Jia Jin1, Tang-Feng Lv1 and Yong Song1
1 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
2 The Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
* These authors have contributed equally to this study
Tang-feng Lv, email:
Yong Song, email:
Keywords: erlotinib, targeted therapy, advanced non-small cell lung cancer, meta-analysis
Received: November 22, 2016 Accepted: March 15, 2017 Published: May 31, 2017
Background: To assess the efficacy profile of erlotinib-based doublet targeted therapy compared with erlotinib monotherapy for previously treated patients with advanced NSCLC, a meta-analysis was performed.
Patients and methods: We rigorously searched PubMed, Embase, Cochrane and meeting proceedings. Phase II/III randomized trials reporting on the efficacy of erlotinib-doublet therapy versus single-agent therapy were selected. We estimated the HR for OS, PFS and the RR for ORR, DCR, 1-year SR. Phases of trials, targeted signaling pathways, EGFR-status and KRAS- status were included in subset analysis.
Results: 24 studies involving 6,196 patients were eligible. In general, the combination targeted therapy significantly improved PFS, ORR and DCR. There was also a trend showing improved OS and 1-year SR in doublets group, though it was not statistically significant. Subgroup analysis suggested PFS improvement in EGFR wild-type, KRAS mutant, KRAS wild-type populations. Moreover, patients treated with anti-angiogenesis or anti-MET targeted agent revealed a significant benefit in PFS.
Conclusion: In patients with advanced NSCLC, erlotinib-doublets target therapy (specially combination with anti-angiogenesis and anti-MET targeted agents) was associated with a statistically significantly longer PFS, greater ORR and DCR, but the combination did not improve OS and 1-year SR compared with erlotinib alone.
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