Effectiveness and safety of crizotinib in the treatment of non-small cell lung cancer: a systematic review_West China Medical Journal

Authors：

TIAN Fangyuan ^1,2 , WU Bin ¹ , ZHAN Mei ¹ , HU Qiaozhi ^1,2 , JIANG Xuehua ² ,  XU Ting ¹

1. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

XU Ting, Email: tingx2009@163.com

Keywords：

Non-small cell lung cancer; Crizotinib; Chemotherapy; Systematic review

DOI：

10.7507/1002-0179.201604231

Video：

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ObjectiveTo systematically review the efficacy and safety of crizotinib in the treatment of non-small cell lung cancer (NSCLC).MethodWe electronically searched databases including the Cochrane Library (Issue 5, 2017), PubMed, Embase, China Biology Medicine Database, China National Knowledge Internet Database, VIP Database and Wangfang Data from the establishment to May 2017. The randomized controlled trials (RCTs), non-RCTs, case series and case reports on crizotinib for NSCLC were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the methodological quality of included studies, then make Meta-analysis and descriptive analysis.ResultA total of 15 studies were included, including 4 RCTs, 1 non-RCT, 4 case series and 6 case reports. The results indicated that the progression-free survival time of crizotinib group was 8 months, which was better than chemotherapy group (4.6 months). The results of Meta-analysis showed that the response rate in the crizotinib group was higher than that in the chemotherapy group [RR=2.35, 95%CI (1.59, 3.46), P<0.000 1]. The one year survival rate in the crizotinib group was 74.5%-78.6%. The incidences of adverse reactions including dysopsia, dysgeusia, diarrhea, vomiting, constipation, transaminase lifts, upper respiratory tract infection, edema and dizziness in the crizotinib group were higher than those in the chemotherapy group (P<0.05), while the incidences of adverse reactions including leukopenia, thrombocytopenia, alopecia and fatigue in crizotinib group were lower than those in the chemotherapy group (P<0.05). Subgroup analysis under precision treatment showed the progression-free survival time of anaplastic lymphoma kinase (ALK)-positive group was 8 months, and it was longer than ALK-negative group of 4 months.ConclusionsBased on current evidence, crizotinib is better than chemotherapy for NSCLC. Due to limited quality of the included studies, the above conclusion needs to be verifed by more high quality studies.

Citation： TIAN Fangyuan, WU Bin, ZHAN Mei, HU Qiaozhi, JIANG Xuehua, XU Ting. Effectiveness and safety of crizotinib in the treatment of non-small cell lung cancer: a systematic review. West China Medical Journal, 2017, 32(7): 993-999. doi: 10.7507/1002-0179.201604231 Copy

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1. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2095-2128.
2. 占美, 徐珽, 吴逢波, 等. 酪氨酸激酶抑制剂联合化疗治疗非小细胞肺癌的系统评价. 中国医院药学杂志, 2014, 34(17): 1489-1495.
3. 赵静, 张坤, 张力予, 等. 克唑替尼治疗 ALK 阳性晚期非小细胞肺癌患者的疗效观察. 中国肺癌杂志, 2015, 18(10): 616-620.
4. Ettinger DS, Wood DE, Akerley W, et al. Non-small cell lung cancer, version 6. 2015. JNCCN, 2015, 13(5): 515-524.
5. Shaw AT, Kim DW, Nakagawa K, et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. N Engl J Med, 2013, 368(25): 2385-2394.
6. Edge SB, Byrd DR, Compton CC. AJCC cancer staging manual. 7th ed. Chicago: American Joint Committee on Cancer, 2010.
7. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5. 1. 0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochranehandbook.org.
8. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
9. Solomon BJ, Mok T, Kim DW, et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer. N Engl J Med, 2014, 371(23): 2167-2177.
10. 王焱, 乔蕾, 孟春, 等. 克唑替尼治疗 EML4-ALK 阳性晚期非小细胞肺癌的临床疗效观察. 中国实用医药, 2014, 9(24): 157-158.
11. 吴璇, 李建雄. 克唑替尼治疗 EML4-ALK 重排阳性患者的临床疗效. 南方医科大学学报, 2015, 35(5): 753-757.
12. Camidge DR, Bang YJ, Kwak EL, et al. Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer: updated results from a phase 1 study. Lancet Oncol, 2012, 13(10): 1011-1019.
13. 郑明英, 张力. 克唑替尼治疗 ALK 融合基因阳性的晚期非小细胞肺癌患者的疗效分析. 癌症进展, 2015, 13(1): 83-86.
14. 刘雨桃, 王子平, 胡兴胜, 等. 克唑替尼对 ALK 融合基因阳性脑转移肺癌患者的疗效分析. 中国新药杂志, 2015, 24(15): 1760-1764.
15. 黄伟, 王琳, 秦叔逵, 等. 克唑替尼治疗 ALK 阳性非小细胞肺癌脑转移的疗效观察. 中国癌症杂志, 2015, 25(6): 467-471.
16. 蒋燕, 孙晓云. 克唑替尼治疗非小细胞肺癌的护理. 中国保健营养: 下旬刊, 2014, 24(2): 933-934.
17. 武勇辉, 张健, 吴伟彬. 克唑替尼治疗 EML4-ALK 阳性晚期非小细胞肺癌化疗后进展 1 例并文献复习. 大家健康: 下旬版, 2015, 9(5): 156-157.
18. 王伟兰, 张超, 朱曼. 从一例肺癌伴疼痛患者探讨克唑替尼与阿片类止痛药的相互作用//2013 年中国药学大会暨第十三届中国药师周论文集. 南宁, 2013: 1-6.
19. 乔昱, 马家芳, 张萍, 等. Alk 阳性肺腺癌卵巢转移 1 例报道. 肿瘤, 2015, 35(7): 806-809.
20. 穆晶, 吴卫华, 蔡毅然, 等. ALK 阳性并克唑替尼治疗有效肺鳞状细胞癌临床病理分析. 临床和实验医学杂志, 2015, 14(11): 919-922.
21. 陈雪姣, 王朝杰, 白冰, 等. 克唑替尼治疗 1 例晚期 ALK 阴性非小细胞肺癌的疗效分析及文献复习. 分子影像学杂志, 2015, 38(3): 311-312.

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