Gefitinib versus docetaxel in previously treated advanced non-small-cell lung cancer: A meta-analysis of randomized controlled trials

Authors

  • Jingwei Jiang Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200040, China
  • Lizhen Huang Department of Laboratory Animal Centre, Southern Medical University, Guangzhou 510515, China
  • Xiaohua Liang Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200040, China
  • Xinli Zhou Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200040, China
  • Ruofan Huang Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200040, China
  • Zhaohui Chu Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200040, China
  • Qiong Zhan Department of Oncology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200040, China

DOI:

https://doi.org/10.3109/0284186X.2010.546368

Abstract

Purpose. A meta-analysis of randomized controlled trials was performed to compare the efficacy, quality of life (QOL), symptom improvement and toxicities of gefitinib with docetaxel in previously treated advanced non-small-cell lung cancer. Methods. The PubMed database, the Cochrane Library and references of published trials were searched. Two reviewers independently assessed the quality of the trials and extracted data. The hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), relative risks (RRs) for overall response rate, QOL and symptom improvement, and odds ratios (ORs) for main toxicities were pooled using STATA package. Results. Four multicenter, randomized controlled trials involving 2257 patients with previously treated advanced NSCLC were ultimately analyzed. The pooled HRs showed no significant difference in OS and PFS between the two groups (HR = 1.02, 95% CI = 0.92–1.12, p = 0.70; HR = 0.97, 95% CI = 0.88–1.07, p = 0.57, respectively). Gefitinib significantly improved overall response rate (RR = 1.58, 95% CI = 1.02–2.45, p = 0.04) and QOL (RR = 1.55, 95% CI = 1.27–1.88, p = 0.00 by Functional Assessment of Cancer Therapy-Lung and RR = 1.86, 95% CI = 1.43–2.42, p = 0.00 by Trial Outcome Index, respectively). Gefitinib had fewer grade 3 or 4 neutropenia and fatigue (OR = 0.02, 95% CI = 0.01–0.03, p = 0.00; and OR = 0.47, 95% CI = 0.32–0.70, p = 0.00, respectively), but more grade 3 or 4 rash (OR = 2.87, 95% CI = 1.24–6.63, p = 0.01) than docetaxel. The grade 3 or 4 nausea, vomiting and diarrhea and symptom improvement were comparable between the two drugs. Conclusions. In conclusion, although similar OS and PFS, gefitinib showed an advantage over docetaxel in terms of objective response rate, QOL and tolerability. Therefore, gefitinib is an important and valid treatment option for previously treated advanced non-small-cell lung cancer patients.

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Published

2011-05-01

How to Cite

Jiang, J., Huang, L., Liang, X., Zhou, X., Huang, R., Chu, Z., & Zhan, Q. (2011). Gefitinib versus docetaxel in previously treated advanced non-small-cell lung cancer: A meta-analysis of randomized controlled trials. Acta Oncologica, 50(4), 582–588. https://doi.org/10.3109/0284186X.2010.546368

Issue

Vol. 50 No. 4 (2011): Acta Oncologica

Section

Articles