Abstract
ObjectivesA role for erlotinib and bevacizumab as single agents has been established in the treatment of non-small cell lung cancer (NSCLC). However, the efficacy and safety of erlotinib in combination with bevacizumab compared with single agents remain unclear. This meta-analysis aimed to investigate the status of this combined strategy in NSCLC. Materials and methodsWe systematically searched relevant databases for randomized controlled trials (RCTs) on the use of erlotinib plus bevacizumab in NSCLC. The main outcomes analysis reported overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse effects. Random-effects models were used to estimate pooled hazard ratio and relative risk. ResultsTen studies with a total of 2802 participants were eligible for meta-analysis, the results of which suggested erlotinib with bevacizumab failed to significantly enhance either OS (95% CI: 0.87–1.12; P = 0.825) or ORR (95% CI: 0.69–1.67; P = 0.758). Though PFS was modestly improved, there was no statistical significance (5.55 months vs. 4.67 months, 95% CI: 0.63–1.15; P = 0.297). Incidence of rash or diarrhea was higher in the combination group than in the single-agent group. Subgroup analysis showed encouraging OS (95% CI: 0.29–0.69; P < 0.001) in epidermal growth factor receptor (EGFR)-mutant patients treated with combination therapy, no such benefits were found in groups restricting on KRAS status. ConclusionErlotinib plus bevacizumab enhances OS for EGFR-mutant patients, with rash and diarrhea common but acceptable adverse effects. Combination treatment can be recommended as the preferable option for EGFR-mutant patients. Further large-scale, well-designed RCTs are required to confirm our validation.
Published Version
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