Chinese Journal of Lung Cancer (Dec 2009)
Erlotinib in the trentment of Advanced Non-small-cell Lung Cancer: A Systematic Review
Abstract
Background and objective Erlotinib is a new and efficient anti-tumor targeted therapy drug, and it has been used in China for non-small cell lung cancer since 2006. The aim of this study is to review the effectiveness and safety of erlotinib for treating advanced non-small cell lung cancer. Methods Authors searched the Cochrane Library, Pubmed, Embase, CBM, CNKI and Wanfang Date. The randomized controlled trials (RCTs) were analyzed by RevMan 4.2 software. Authors also included retrospective case report published in Chinese journals. Results Four RCTs and 8 uncontrolled case reports were analyzed. The results of the RCTs showed that erlotinib was significantly better than placebo on progression-free survival, median survival time, response rate (OR=10.21, 95%CI: 2.44-42.73) and 1-yr survival rate (OR=1.67, 95%CI: 1.13-2.46); Erlotinib was superior than paclitaxel+carboplatin on median survival time (HR=1.73, 95%CI: 1.09-2.73; P=0.018), the other efficacy were similar; The efficacy of erlotinib combined chemotherapy was close to chemotherapy alone. The main side effects caused by erlotinib were rash and diarrhea, and the tolerance was well. The overall uncontrolled clinical studies showed that the response rate was 27.27%, and the 1-yr survival rate was 56.1%. Conclusion Erlotinib is effect for non-small cell lung cancer, and maybe better for never smokers, female, Asia and adenocarcima. The clinical favor from erlotinib combined chemotherapy remains uncertain. But the effect of erlotinib being used in clinical settings needs to be confirmed by further large and multicenter.
