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Efficacy and Safety of Gefitinib or Platinum plus Taxane in Egfr-Mutant Advanced Non-Small Cell Lung Cancers: A Meta-Analysis of First-Line Randomized Controlled Trials

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DOI: 10.4236/jct.2012.324060    3,735 Downloads   5,996 Views  
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ABSTRACT

Purpose: The discovery of EGFR mutations renewed interest in lung cancer translational research since EGFR-dependent pathway plays an important role in the development and progression of human epithelial cancers, including non-small cell lung cancer (NSCLC). The present meta-analysis was performed to review the recent advances with the selective oral EGFR-TK inhibitor gefitinib among EGFR mutation positive patients with NSCLC. Methods: Using the keywords “gefitinib” and “lung cancer” MEDLINE was searched. The primary reports of interest were the randomized controlled trials in NSCL published in peer-reviewed journals. Three recent studies concerning the effect of gefitinib in NSCLC were identified to be relevant for the meta-analysis based on their similarity in terms of study design. PFS and objective response rate (ORR) in gefitinib and platinum/taxane combination were compared by the Hazard ratio (HR) or Odds Ratio (OR) of meta-analysis. Results: The HR (95%CI) of the meta-analysis of 0.41 (0.34 - 0.49) demonstrated that in patients EFGR mutation positive patients, PFS was significantly longer among those who received gefitinib compared to platin derivative/taxane combination. Furthermore, OR of the meta-analysis for ORR was 3.83 (2.72 - 5.40). While hematological toxicity was observed in the majority of the taxane/platinum group, major adverse events in gefitinib patients were skin rashes/acnea, dry skin, elevated liver enzymes and diarrhea. Conclusions: This meta-analysis strongly confirms the efficacy and better tolerability of gefitinib in EGFR positive NSCLC, and the importance of EGFR mutation testing in order to plan first-line treatment in routine clinical practice in NSCLC.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

A. Aydiner, "Efficacy and Safety of Gefitinib or Platinum plus Taxane in Egfr-Mutant Advanced Non-Small Cell Lung Cancers: A Meta-Analysis of First-Line Randomized Controlled Trials," Journal of Cancer Therapy, Vol. 3 No. 4A, 2012, pp. 467-476. doi: 10.4236/jct.2012.324060.

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