PDF(Pubmed)
Abstract：
UNASSIGNED: Leptomeningeal metastasis (LM) is a severe complication of non-small cell lung cancer (NSCLC). In patients with NSCLC LM harboring epidermal growth factor receptor (EGFR) mutations, osimertinib is favored over alternative EGFR tyrosine kinase inhibitors (TKIs). However, the efficacy of osimertinib relative to other EGFR-TKIs is not well established for patients with LM. We aimed to compare the efficacy of EGFR-TKIs in EGFR-mutated NSCLC LM.
UNASSIGNED: This systematic review and meta-analysis performed according to PRISMA guidelines included studies of adult patients with EGFR-mutated NSCLC and a diagnosis of LM who received an EGFR-TKI for the treatment of LM. We searched Medline ALL, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science Core Collection. The evaluation of biases was done by using the Ottawa-Newscastle scale. The hazard ratio was used as the parameter of interest for overall survival (OS) and central nervous system-specific progression-free survival (PFS).
UNASSIGNED: 128 publications were included with 243 patients and 282 lines of EGFR-TKI for NSCLC LM that met inclusion criteria. The median PFS in patients receiving any EGFR-TKI was 9.1 months, and the median OS was 14.5 months. In univariate analyses of the entire cohort, osimertinib treatment demonstrated significantly prolonged PFS, but not OS, compared to other EGFR-TKIs. Osimertinib demonstrated significantly prolonged PFS and OS in the subset of patients who were previously treated with EGFR-TKIs, but not in EGFR-TKI naïve patients.
UNASSIGNED: Osimertinib is associated with improved outcomes compared to other EGFR-TKIs, particularly in patients previously treated with EGFR-TKIs. An important limitation is that most patients were derived from retrospective reports. These results highlight the need for prospective studies for this difficult-to-treat patient population.
UNASSIGNED: This systematic review and meta-analysis performed according to PRISMA guidelines included studies of adult patients with EGFR-mutated NSCLC and a diagnosis of LM who received an EGFR-TKI for the treatment of LM. We searched Medline ALL, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science Core Collection. The evaluation of biases was done by using the Ottawa-Newscastle scale. The hazard ratio was used as the parameter of interest for overall survival (OS) and central nervous system-specific progression-free survival (PFS).
UNASSIGNED: 128 publications were included with 243 patients and 282 lines of EGFR-TKI for NSCLC LM that met inclusion criteria. The median PFS in patients receiving any EGFR-TKI was 9.1 months, and the median OS was 14.5 months. In univariate analyses of the entire cohort, osimertinib treatment demonstrated significantly prolonged PFS, but not OS, compared to other EGFR-TKIs. Osimertinib demonstrated significantly prolonged PFS and OS in the subset of patients who were previously treated with EGFR-TKIs, but not in EGFR-TKI naïve patients.
UNASSIGNED: Osimertinib is associated with improved outcomes compared to other EGFR-TKIs, particularly in patients previously treated with EGFR-TKIs. An important limitation is that most patients were derived from retrospective reports. These results highlight the need for prospective studies for this difficult-to-treat patient population.
摘要：
■脑膜转移（LM）是非小细胞肺癌（NSCLC）的严重并发症。在携带表皮生长因子受体（EGFR）突变的NSCLCLM患者中，奥希替尼优于替代EGFR酪氨酸激酶抑制剂（TKIs）。然而,对于LM患者,奥希替尼相对于其他EGFR-TKIs的疗效尚不明确.我们旨在比较EGFR-TKIs在EGFR突变的NSCLCLM中的疗效。
■根据PRISMA指南进行的系统评价和荟萃分析包括对患有EGFR突变的NSCLC的成年患者和接受EGFR-TKI治疗的LM诊断的研究。我们全部搜索了Medline,Embase,Cochrane中央控制试验登记册,Scopus,和WebofScience核心合集。偏差的评估是通过使用渥太华-Newscastle量表进行的。风险比用作总生存期(OS)和中枢神经系统特异性无进展生存期(PFS)的感兴趣参数。
■128篇出版物纳入243例符合纳入标准的NSCLCLM患者和282株EGFR-TKI。接受任何EGFR-TKI的患者的中位PFS为9.1个月，中位OS为14.5个月。在整个队列的单变量分析中，奥希替尼治疗显著延长PFS，但不是操作系统，与其他EGFR-TKIs相比。奥希替尼在先前接受EGFR-TKIs治疗的患者亚组中表现出显著延长的PFS和OS。但不在EGFR-TKI初治患者中。
■与其他EGFR-TKIs相比，奥希替尼的预后改善相关，特别是以前接受过EGFR-TKIs治疗的患者。一个重要的限制是大多数患者来自回顾性报告。这些结果强调了对这种难以治疗的患者群体进行前瞻性研究的必要性。
■根据PRISMA指南进行的系统评价和荟萃分析包括对患有EGFR突变的NSCLC的成年患者和接受EGFR-TKI治疗的LM诊断的研究。我们全部搜索了Medline,Embase,Cochrane中央控制试验登记册,Scopus,和WebofScience核心合集。偏差的评估是通过使用渥太华-Newscastle量表进行的。风险比用作总生存期(OS)和中枢神经系统特异性无进展生存期(PFS)的感兴趣参数。
■128篇出版物纳入243例符合纳入标准的NSCLCLM患者和282株EGFR-TKI。接受任何EGFR-TKI的患者的中位PFS为9.1个月，中位OS为14.5个月。在整个队列的单变量分析中，奥希替尼治疗显著延长PFS，但不是操作系统，与其他EGFR-TKIs相比。奥希替尼在先前接受EGFR-TKIs治疗的患者亚组中表现出显著延长的PFS和OS。但不在EGFR-TKI初治患者中。
■与其他EGFR-TKIs相比，奥希替尼的预后改善相关，特别是以前接受过EGFR-TKIs治疗的患者。一个重要的限制是大多数患者来自回顾性报告。这些结果强调了对这种难以治疗的患者群体进行前瞻性研究的必要性。
