Efficacy Of Erlotinib Versus Chemotherapy In The Second-line Therapy Of Advanced Non-small-cell Lung Cancer:A Meta-Analysis

Objective:To systematically evaluate the efficacy and safety of erlotinib versus chemotherapy as second-line treatment in patients with advanced non-small cell lung cancer (NSCLC).Methods:We searched The Cochrane Library (Issue 7,2014),Web of Science (1966-2014-07),EMbase (1900-2014-07) PubMed (1966-2014-07) CBM(1978-2014-07),CNKI(1994-2014-07)and WanFang Data(1989-2014-07).Data Analyses was conducted using RevMan5.2 software.Results:The final analysis included six trials,covering 1,396 patients.The results of meta-analyses showed that:erlotinib was not significantly improved progression-free survival (PFS) [HR=0.98,95%CI(0.86-1.12), P=0.77] and overall survival(OS)[HR=0.93,95%CI(0.81-1.07),P=0.31)]compared with chemotherapy,subgroup analysis showed the PFS and OS in two groups had no significant difference in smoking state and gender as well as in patients with wild-type EGFR; However.compared with chemotherapy group,erlotinib combined with chemotherapy significantly improved PFS[HR=0.61,95%CI (0.47-0.79),P=0.0002] and OS[HR=0.71,95%CI(0.54-0.94),P=0.02)] in second-line non-squamous non-small cell lung cancer.The main adverse reactions caused by erlotinib were tolerable rash and diarrhea.Conlusion:Erlotinib monotherapy in second-line treatment of non-small cell lung cancer did not show superiority,erlotinib in combination with chemotherapy for advanced non-squamous non-small cell lung cancer prolongs the patient’s PFS and OS.The main adverse reactions caused by erlotinib were tolerable rash and diarrhea.