J Cancer 2018; 9(8):1455-1465. doi:10.7150/jca.23356

Research Paper

The Efficacy and Toxicity of Gefitinib in Treating Non-small Cell Lung Cancer: A Meta-analysis of 19 Randomized Clinical Trials

Hongmei Wo1, Jing He2, Yang Zhao2, Hao Yu2, Feng Chen2✉, Honggang Yi2✉

1. Department of Health Economics, School of Health Policy and Management, Nanjing Medical University, Nanjing, 211166, China
2. Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China

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Citation:
Wo H, He J, Zhao Y, Yu H, Chen F, Yi H. The Efficacy and Toxicity of Gefitinib in Treating Non-small Cell Lung Cancer: A Meta-analysis of 19 Randomized Clinical Trials. J Cancer 2018; 9(8):1455-1465. doi:10.7150/jca.23356. Available from http://www.jcancer.org/v09p1455.htm

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Abstract

Background: This meta-analysis evaluated the efficacy and toxicity of gefitinib with other commonly used drugs in different treatment settings and epidermal growth factor receptor (EGFR) mutation status.

Methods: Nineteen randomize clinical trials (RCTs) of 6,554 patients with NSCLC were pooled in this meta-analysis by random-effects or fixed-effects model, whichever is proper.

Results: In first-line therapy, gefitinib showed higher odds than chemotherapy (OR = 2.19, 95% CI: 1.20-4.01), but less than other targeted therapies (OR = 0.58, 95% CI: 0.38-0.88). As non-first-line therapy, the overall survival (OS) and progression-free survival (PFS) were similar between gefitinib and controls (HR = 1.00, 95% CI: 0.93-1.08; HR = 0.91, 95% CI: 0.72-1.15), respectively. With the regard to toxicity, the incidences of dry skin, rash and pruritus were higher in gefitinib compared with controls, while gefitinib significantly reduced the incidence of hematologic toxicity.

Conclusion: Gefitinib might be more efficient than chemotherapy, but less efficient than other targeted therapies in ORR, especially in EGFR mutation-positive patients. Gefitinib can decrease the odds of hematologic toxicity compared to controls. Future studies, especially those with EGFR mutation-positive patients, will be needed to confirm our findings.

Keywords: gefitinib, non-small cell lung cancer, meta-analysis, efficacy, toxicity.