非小细胞肺癌EGFR基因不同突变位点对TKI治疗反应的meta分析  

Meta-analysis of responses to TKI in different EGFR gene mutation sites with non-small cell lung cancer

作　　者：柯张延 张志红[1] 张妍蓓[1] 宁雅静[1] 徐珂 Ke Zhangyan;Zhang Zhihong;Zhang Yanbei(Dept of Cadre Respiratory and Critical Care,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院干部呼吸与危重症科

出　　处：《安徽医科大学学报》2019年第7期1101-1108,共8页Acta Universitatis Medicinalis Anhui

基　　金：安徽高校自然科学研究项目(编号:KJ2018A0208)

摘　　要：目的比较表皮生长因子受体(EGFR)中外显子19缺失和外显子21 L858R替换两个突变位点对酪氨酸激酶抑制剂(TKI)的反应。方法以"NSCLC""non-small cell lung cancer""mutation""exon""TKI""tyrosine kinase inhibitors""EGFR""epidermal growth factor receptor"为关键词检索公开发表在Pubmed、Embase和Cochran Library上的关于不同基因位点对TKI治疗疗效的临床试验,检索期限为数据库建库至2018年2月1日,采用Revman 5.3软件进行数据分析。结果 27篇文献纳入分析,结果提示:外显子19缺失的非小细胞肺癌(NSCLC)患者在进行TKI治疗时可获得更长的无进展生存期(PFS)(HR=0.66,P<0.001)和总体生存期(OS)(HR=0.75,P<0.001),也可获得更好的客观缓解率(ORR)(OR=0.11,P<0.001)和疾病控制率(DCR)(OR=2.01,P=0.03)。结论 EGFR外显子19缺失突变是预测NSCLC患者对TKI治疗反应的较为敏感的指标,并且较外显子21 L858R替换的患者可以获得更好的疗效。Objective To compared the response of exon 19 del and exon 21 L858 R substitute in EGFR to tyrosinekinase inhibitors( TKIs). Methods Relevant studies were retrieved from databases including PubMed,Embase,Cochrane Library,and the keywords including "NSCLC""non-small cell lung cancer""mutation""exon""TKI""tyrosine kinase inhibitors""EGFR""epidermal growth factor receptor",dated from construction until February1,2018. Meta-analysis was carried out using Revman 5. 3 software. Results A total of 27 articles were included in the analysis. The results suggested that non-small cell lung cancer( NSCLC) patients with exon 19 deletion can achieve longer progression-free survival( PFS)( HR = 0. 66,P < 0. 001) and overall survival( OS) when treated with TKI,( HR = 0. 75,P < 0. 001),also achieved better objective response rate( ORR)( OR = 0. 11,P <0. 001) and disease control rate( DCR)( OR = 2. 01,P = 0. 03). Conclusion EGFR exon 19 del mutation is more sensitive for predicting TKI response in patients with non-small cell lung cancer,and it can achieve better efficacy than the substitute of exon 21 L858 R.

关 键 词：表皮生长因子受体 基因突变 非小细胞肺癌 META分析 

分 类 号：R734.2[医药卫生—肿瘤]