Chinese Clinical Oncology

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Gefitinib versus chemotherapy in the first-line treatment of advanced non-small cell lung cancer:a meta-analysis

QIAO Jianbing,CHEN Wenping   

  1. Department of Medical Respiration,Chest Hospital,Nanjing 210029,China
  • Received:2012-11-04 Revised:2012-12-24 Online:2013-05-31 Published:2013-05-31
  • Contact: CHEN Wenping

Abstract: Objective To assess the efficacy and safety of gefitinib versus platinumbased chemotherapy for patients with advanced nonsmall cell lung cancer(NSCLC). Methods Such databases as PubMed,Embase,CBM and CNKI were searched to collect the randomized controlled trials comparing gefitinib to platinum-based thirdgeneration chemotherapy as the first-line treatment of advanced NSCLC published before March of 2012. Stata 100 software was used for metaanalysis. Results Four studies involving 1926 patients were included. The result of meta-analysis showed that in patients with known epidermal growth factor receptor(EGFR)mutations or whose tumors likely to harbor a mutation,gefitinib was better than chemotherapy in progress free survival and effective rate(HR=0.43,95%CI:0.32-0.58,P<0.001;71.5% vs.38.1%,OR=4.04,95%CI:2.90-5.61,P<0.001),and there was no significant difference between the two groups in the overall survival (HR=0.93,95%CI:0.75-1.15,P=0.492). In the aspect of safety,the major adverse events for gefitinib were rash,diarrhea and aminotransferase elevation,whereas platinum-based chemotherapy was associated with more neutropenia,anemia and thrombocytopenia.
Conclusion Gefitinib shows more superiority and can be used as the first-line drug for EGFR-mutated advanced NSCLC.

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