Abstract
Aim: To assess the efficacy and safety of EGFR inhibitors combined with (chemo)radiotherapy in unresectable, locally advanced non-small-cell lung cancer. Materials & methods: A systematic review and meta-analysis of prospective trials was performed. Results: Twenty-eight studies of 1640 patients were included. In patients harboring EGFR-sensitive mutations, the pooled objective response rate, 1-year overall survival rate and 1-year progression-free survival rate of EGFR-TKIs + (chemo)radiotherapy were 0.803, 0.766 and 0.554, respectively. Compared with chemoradiotherapy, the addition of EGFR inhibitors did not significantly increase the risk of grade ≥3 pneumonitis and esophagitis. Conclusion: EGFR-tyrosine kinase inhibitors combined with (chemo)radiotherapy are tolerable and the clinical benefit is promising, especially in patients with EGFR-sensitive mutations.
Plain language summary
The aim of this systemic review and meta-analysis was to assess the efficacy and safety of (chemo)radiotherapy combined with therapies targeting EGFR receptor, in unresectable, locally advanced non-small-cell lung cancer. Prospective clinical trials were searched and analyzed, and 28 studies of 1640 patients were included in this analysis. The results showed that the efficacy of (chemo)radiotherapy combined with tyrosine kinase inhibitors targeting EGFR, such as gefitinib and erlotinib, was promising, especially among patients harboring sensitive mutations in EGFR. Besides, this combination therapy was safe, which did not increase the risk of severe pneumonitis and esophagitis. Overall, tyrosine kinase inhibitors targeting EGFR combined with (chemo)radiotherapy are tolerable and the clinical benefit is promising, especially in patients with EGFR-sensitive mutations.
Supplementary data
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Author contributions
All authors had full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. X Li: conceptualization, data curation, formal analysis; F Wang: methodology, data curation, formal analysis; H Jia: investigation, writing – original draft; Z Lian: visualization; K Ren: software; Z Yuan: validation; P Wang: writing – review editing; L Zhao: supervision, project administration.
Financial & competing interests disclosure
This study was sponsored by the grant from National Natural Science Foundation of China (no. 81903121). X Li received funding to conduct this research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.