Impact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
Background and Aim: As one of the second-generation epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors, afatinib brings survival benefits to patients with common and rare EGFR mutations. This study aimed to compare the effectiveness and safety of 30 and 40 mg of afatinib in patients...
Guardado en:
| Autores principales: | , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Frontiers Media S.A.
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/141141d8ba5e45638b91ec4a1295f7d2 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:141141d8ba5e45638b91ec4a1295f7d2 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:141141d8ba5e45638b91ec4a1295f7d22021-12-01T13:14:40ZImpact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis1663-981210.3389/fphar.2021.781084https://doaj.org/article/141141d8ba5e45638b91ec4a1295f7d22021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.781084/fullhttps://doaj.org/toc/1663-9812Background and Aim: As one of the second-generation epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors, afatinib brings survival benefits to patients with common and rare EGFR mutations. This study aimed to compare the effectiveness and safety of 30 and 40 mg of afatinib in patients with non–small cell lung cancer (NSCLC) using qualitative and quantitative analysis methods so as to provide reference for clinical medication.Methods: The PubMed, Embase, ClinicalTrials.gov, Cochrane Library, China National Knowledge Infrastructure, and WanFang databases were thoroughly searched from inception to February 26, 2021. Two researchers independently screened the literature, extracted data, and evaluated the quality. RevMan and Stata 15.0 were used for meta-analysis.Results: Twelve cohort studies including 1290 patients for final analysis were selected; of which, 1129 patients were analyzed to measure the effectiveness outcomes and 470 patients were analyzed for safety outcomes. In patients with non-brain metastasis, the progression-free survival of the first- or second-line treatment with reduced-dose afatinib was equivalent to the conventional dose. In terms of safety, the reduced dose could significantly lower the incidence of severe diarrhea and severe rash, but not the total incidence of diarrhea, rash, and all levels of paronychia.Conclusions: The incidence of common serious adverse reactions was significantly lower with 30 mg of afatinib than with 40 mg of afatinib in patients with NSCLC. The effectiveness appeared to be similar to that in patients with non-brain metastasis. This study provides a reference for clinical dose reduction of afatinib.Systematic Review Registration: [PROSPERO], identifier [CRD42021238043]Ziyu WangZiyu WangXin DuXin DuKen ChenShanshan LiZhiheng YuZhiheng YuZiyang WuLi YangDingding ChenWei LiuFrontiers Media S.A.articleafatinibnon–small cell lung cancerdose reductioneffectivenesssafetymeta-analysisTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
afatinib non–small cell lung cancer dose reduction effectiveness safety meta-analysis Therapeutics. Pharmacology RM1-950 |
| spellingShingle |
afatinib non–small cell lung cancer dose reduction effectiveness safety meta-analysis Therapeutics. Pharmacology RM1-950 Ziyu Wang Ziyu Wang Xin Du Xin Du Ken Chen Shanshan Li Zhiheng Yu Zhiheng Yu Ziyang Wu Li Yang Dingding Chen Wei Liu Impact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis |
| description |
Background and Aim: As one of the second-generation epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors, afatinib brings survival benefits to patients with common and rare EGFR mutations. This study aimed to compare the effectiveness and safety of 30 and 40 mg of afatinib in patients with non–small cell lung cancer (NSCLC) using qualitative and quantitative analysis methods so as to provide reference for clinical medication.Methods: The PubMed, Embase, ClinicalTrials.gov, Cochrane Library, China National Knowledge Infrastructure, and WanFang databases were thoroughly searched from inception to February 26, 2021. Two researchers independently screened the literature, extracted data, and evaluated the quality. RevMan and Stata 15.0 were used for meta-analysis.Results: Twelve cohort studies including 1290 patients for final analysis were selected; of which, 1129 patients were analyzed to measure the effectiveness outcomes and 470 patients were analyzed for safety outcomes. In patients with non-brain metastasis, the progression-free survival of the first- or second-line treatment with reduced-dose afatinib was equivalent to the conventional dose. In terms of safety, the reduced dose could significantly lower the incidence of severe diarrhea and severe rash, but not the total incidence of diarrhea, rash, and all levels of paronychia.Conclusions: The incidence of common serious adverse reactions was significantly lower with 30 mg of afatinib than with 40 mg of afatinib in patients with NSCLC. The effectiveness appeared to be similar to that in patients with non-brain metastasis. This study provides a reference for clinical dose reduction of afatinib.Systematic Review Registration: [PROSPERO], identifier [CRD42021238043] |
| format |
article |
| author |
Ziyu Wang Ziyu Wang Xin Du Xin Du Ken Chen Shanshan Li Zhiheng Yu Zhiheng Yu Ziyang Wu Li Yang Dingding Chen Wei Liu |
| author_facet |
Ziyu Wang Ziyu Wang Xin Du Xin Du Ken Chen Shanshan Li Zhiheng Yu Zhiheng Yu Ziyang Wu Li Yang Dingding Chen Wei Liu |
| author_sort |
Ziyu Wang |
| title |
Impact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis |
| title_short |
Impact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis |
| title_full |
Impact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr |
Impact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed |
Impact of Dose Reduction of Afatinib Used in Patients With Non–Small Cell Lung Cancer: A Systematic Review and Meta-Analysis |
| title_sort |
impact of dose reduction of afatinib used in patients with non–small cell lung cancer: a systematic review and meta-analysis |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/141141d8ba5e45638b91ec4a1295f7d2 |
| work_keys_str_mv |
AT ziyuwang impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT ziyuwang impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT xindu impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT xindu impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT kenchen impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT shanshanli impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT zhihengyu impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT zhihengyu impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT ziyangwu impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT liyang impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT dingdingchen impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis AT weiliu impactofdosereductionofafatinibusedinpatientswithnonsmallcelllungcancerasystematicreviewandmetaanalysis |
| _version_ |
1718405102542258176 |