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Review
. 2024 May 27;9(3):e1279.
doi: 10.1002/lio2.1279. eCollection 2024 Jun.

The efficacy and safety of EGFR-TKI in recurrent/metastatic nasopharyngeal carcinoma patients: A systematic review and meta-analysis

Zeqi An  1 , Libin He  1 , Tuo Chen  1 , Bosen Liang  1 , Qiang Wu  1
Affiliations
Review

The efficacy and safety of EGFR-TKI in recurrent/metastatic nasopharyngeal carcinoma patients: A systematic review and meta-analysis

Zeqi An et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objectives: EGFR-tyrosine kinase inhibitor (TKI) is used to treat recurrent and metastatic nasopharyngeal carcinoma (rmNPC). This meta-analysis aims to study the efficacy and safety of EGFR-TKI in treating patients with rmNPC.

Methods: We conducted a systematic search of PubMed, Embase, and Web of Science up to November 2023, and included literature that met the criteria. We extracted objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and adverse reaction-related events and performed meta-analysis using Stata 14.0.

Results: A total of nine articles were included. The summary results showed that the ORR for patients treated with EGFR-TKI for rmNPC was 38% (95% CI = 27%-49%), the DCR was 71% (95% CI = 61%-80%), the mPFS was 6.29 months (95% CI = 5.22-7.35), and the mOS was 15.94 months (95% CI = 14.68-17.20). The most common grade 3-4 adverse reaction events in these patients were mucositis, nasopharyngeal necrosis, and oral ulceration. We found an incidence rate of 49% (95% CI = 38%-61%) for grade 3-4 adverse events (AEs). The anti-PD1 combined with TKI treatment method is more effective than the EGFR-TKI alone for treating rmNPC.

Conclusion: The study shows that EGFR-TKI has good efficacy in treating rmNPC but does not translate into survival benefits and owns a high incidence of grade 3-4 AEs. More RCT trials are needed in the future to verify the efficacy of anti-PD1 combined with TKI treatment method.

Keywords: EGFR‐TKI; anti‐PD1; immunotherapy; meta‐analysis; nasopharyngeal carcinoma; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram of the study selection process.
FIGURE 2
FIGURE 2
Forest plots of objective response rate (ORR) for the meta‐analysis.
FIGURE 3
FIGURE 3
Forest plots of disease control rate (DCR) for the meta‐analysis.
FIGURE 4
FIGURE 4
Forest plots of median progression‐free survival (mPFS) for the meta‐analysis.
FIGURE 5
FIGURE 5
Forest plots of median overall survival (mOS) for the meta‐analysis.
FIGURE 6
FIGURE 6
Forest plots of the incidence of grade 3–4 events.
See this image and copyright information in PMC

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