請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/84778
標題: | 表皮生長因子受體酪胺酸酶抑制劑併用血管內皮生長因子抑制劑在未接受治療、EGFR突變、晚期非小細胞肺癌:系統性回顧和統合分析、第三期臨床試驗計畫書 EGFR Tyrosine Kinase Inhibitor Plus Anti-VEGF/VEGFR Antibody in Patients with untreated, EGFR-Mutated, Advanced Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis, A Phase III Clinical Trial Protocol |
作者: | Pei-Jung Huang 黃珮榕 |
指導教授: | 林家齊(Chia-Chi Lin) |
關鍵字: | 表皮生長因子受體酪胺酸酶抑制劑,血管內皮生長因子抑制劑,統合分析,晚期非小細胞肺癌, EGFR tyrosine kinase inhibitor,anti-VEGF/VEGFR antibody,meta-analysis,advanced non-small cell lung cancer, |
出版年 : | 2022 |
學位: | 碩士 |
摘要: | 目的-本研究針對隨機分派臨床試驗執行系統性文獻回顧和統合分析,探討尚未接受治療帶有表皮生長因子受體突變的晚期非小細胞肺癌以表皮生長因子受體酪胺酸酶抑制劑併用血管內皮生長因子抑制劑與表皮生長因子受體酪胺酸酶抑制劑單獨使用的治療效果以及安全性。 方法-從電子資料庫及相關會議資料搜尋並進行系統性文獻回顧和統合分析。評估指標包含無疾病惡化存活期(PFS)、整體存活期(OS)、客觀反應率(ORR)、疾病控制率(DCR)及不良事件發生率。使用隨機效應模式合併分析結果。 結果-納入八篇臨床試驗結果進行統合分析。以表皮生長因子受體酪胺酸酶抑制劑併用血管內皮生長因子抑制劑與表皮生長因子受體酪胺酸酶抑制劑單獨使用,無疾病惡化存活期在合併治療組較佳,其危險比(Hazard ratio)為0.61; 95% CI, 0.54-0.69; P < 0.0001;整體存活期、客觀反應率和疾病控制率的危險比在統計上沒有顯著的差異;大於或等於等級3之不良事件發生率的風險比(Risk ratio) 為4.23; 95% CI, 2.64-6.78; P<0.00001。 結論-針對尚未接受治療、表皮生長因子受體突變的晚期非小細胞肺癌,以表皮生長因子受體酪胺酸酶抑制劑併用血管內皮生長因子抑制劑與表皮生長因子受體酪胺酸酶抑制劑單獨使用比較,顯著增加無疾病惡化存活期,大於或等於等級3之不良事件發生率也顯著較高。 Purpose-A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the efficacy and safety of EGFR tyrosine kinase inhibitor (EGFR-TKI) plus anti-VEGF/VEGFR antibody with EGFR-TKI monotherapy for the untreated, EGFR-mutated, advanced NSCLC. Methods-PubMed, Embase, Web of Science, and conference proceedings were searched for relevant RCTs. The endpoints included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), grade 3-5 adverse events, and serious adverse event (SAE). A random-effects model was used. Results-Data were extracted from eight eligible RCTs. PFS significantly improved in combination therapy compared to monotherapy (HR = 0.61, P < 0.0001) regardless of sex, ECOG PS status, EGFR mutation type (exon 19 deletion or L858R), and brain metastasis status (brain metastasis or no metastasis). There were no statistically significant differences for OS (HR = 0.90, P = 0.19), ORR (RR = 1.27, P = 0.05), and DCR (RR = 1.27, P = 0.45). Conclusion-For patients with untreated, EGFR-mutated, advanced NSCLC, the combination of EGFR-TKI plus anti-VEGF/VEGFR antibody, compared to EGFR-TKI alone, prolonged PFS, but did not improve OS, ORR, and DCR. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/84778 |
DOI: | 10.6342/NTU202202991 |
全文授權: | 同意授權(限校園內公開) |
電子全文公開日期: | 2022-10-05 |
顯示於系所單位: | 臨床醫學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
U0001-3008202221283700.pdf 授權僅限NTU校內IP使用(校園外請利用VPN校外連線服務) | 1.39 MB | Adobe PDF | 檢視/開啟 |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。