Efficacy And Safety Of Erlotinib Combined With Gemcitabine In The Treatment Of Pancreatic Cancer: A Meta-analysis

Objective This Meta-analysis aims to assess the efficacy and safety of erlotinib combined with gemcitabine in the treatment of pancreatic cancer.Methods We searched CNKI,Wanfang Database,VIP,Pub Med,EBSCO and Web of Science for randomized controlled trials which comparing the efficacy and safety of erlotinib plus gemcitabine versus gemcitabine alone in the treatment of pancreatic cancer,and extracted the data.Rev Man 5.3 and Stata 15 software were used for Meta analysis.Results A total of 7 studies and 2011 patients with pancreatic cancer were included.Meta-analysis showed that the disease control rate of patients in erlotinib plus gemcitabine group was significantly higher than that in gemcitabine group(RR=1.44,95% CI: 1.11-1.88,P=0.006).However,the erlotinib plus gemcitabine group did not show significant advantages in overall survival(HR=0.90,95% CI: 0.73-1.12,P=0.34),disease-free survival(HR=0.97,95% CI: 0.83-1.14,P=0.72)and progression-free survival(HR=0.80,95% CI: 0.56-1.15,P=0.23).In terms of adverse events(grade 3/4),the risk of diarrhea(RR=3.85,95% CI: 2.22-6.68,P<0.00001)and rash(RR=7.70,95%CI: 3.19-18.62,P<0.00001)in erlotinib plus gemcitabine group was significantly higher than that in gemcitabine group.There was no significant difference in the risk of neutropenia(RR=1.02,95% CI: 0.87-1.20,P=0.81),thrombocytopenia(RR=1.21,95%CI: 0.82-1.80,P=0.34),fatigue(RR=1.12,95% CI: 0.78-1.61,P=0.55)and nausea(RR=1.48,95% CI: 0.55-3.97,P=0.43)between the two groups.Conclusion Erlotinib plus gemcitabine can improve disease control rate compared with gemcitabine alone in the treatment of pancreatic cancer,but it cannot improve the survival benefit,and it increases the risk of diarrhea and skin rash(grade 3/4).