克唑替尼一线治疗晚期非小细胞肺癌伴ROS-1重排的临床疗效:系统评价

M. R. Fadhillah, J. Zaini
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摘要

背景:克唑替尼是一种用于治疗ROS-1重排的晚期NSCLC的药物。然而,尚无综述评估现有研究来确定一线克唑替尼治疗伴有ROS-1重排的晚期NSCLC的有效性和安全性。方法:检索PubMed、Cochrane Library、EBSCOHost和ScienceDirect,按照纳入和排除标准进行筛选,并阅读全文。研究人员总结并提取了疗效作为主要结局,包括患者的最佳反应(完全缓解、部分缓解、病情稳定、病情进展、疾病控制率、客观缓解率)和预后(总生存率和无进展生存率)。安全性也被提取为次要终点。结果:在91篇电子检索的文章中,有4篇观察性研究被纳入、提取并进行描述性总结。全文阅读后,纳入所有研究。在所有研究中,一线克唑替尼的中位PFS从14.9个月、23.0个月和18.4个月不等,中位OS为60天至“无法达到”。患者的最佳反应在研究中是相似的。然而,四分之二的研究没有报告不良事件的结果。这项研究的结论是,一线克唑替尼是安全的。结论:本系统综述提示了克唑替尼一线治疗晚期非小细胞肺癌的疗效。考虑到目前纳入研究的局限性,需要在这一范围内进一步提高后续研究的质量。
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Clinical Efficacy of Crizotinib as the First-Line Therapy of Advanced Non-Small-Cell Lung Carcinoma with ROS-1 Rearrangement: A Systematic Review
Background: Crizotinib is a drug designed to treat advanced NSCLC with ROS-1 rearrangement. Nevertheless, no reviews have assessed available studies to determine the efficacy and safety of first-line crizotinib against advanced NSCLC with ROS-1 rearrangement.Methods: PubMed, Cochrane Library, EBSCOHost, and ScienceDirect, were searched, filtered by inclusion and exclusion criteria, and read the full text. The researchers summarized and extracted efficacy as the primary outcome, including patients’ best response (complete response, partial response, stable disease, progressive disease, disease control rate, and objective response rate) and prognosis (overall survival rate and progression-free survival rate). Safety was also extracted as the secondary outcome.Results: Out of 91 articles electronically searched, four observational studies were included, extracted, and summarized descriptively. After full-text reading, entire studies were included. Across studies, the median PFS of the first line crizotinib varied from 14.9 months, 23.0 months, and 18.4 months with the median OS being 60 days to “Not Reach.” The patients’ best responses were similar among the studies. However, two out of four studies did not report the adverse event outcome. This study concluded that first-line crizotinib was safe.Conclusions: This systematic review suggests the potency of the first line of crizotinib therapy in advanced NSCLC patients. Regarding the current limitation of included studies, further higher quality with subsequent research in this scope is needed.
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