Efficacy and safety of third-generation EGFR-TKIs in patients with non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Abstract Background and objective The third-generation EGFR-TKIs are used in the treatment of non-small cell lung cancer. But its efficacy and safety are still unknown. This meta-analysis was conducted to evaluate the efficacy and safety of the third-generation EGFR-TKIs in randomized controlled trials (RCTs). Methods We searched PubMed, EMBASE, Cochrane Library, and Web of Science for studies in terms of the efficacy and safety of third-generation EGFR-TKIs in patients with non-small cell lung cancer. Meta-analysis was performed using RevMan5.4 and the odds ratio (OR) or the risk ratio (RR) or the weighted mean difference (WMD) with 95% confidence interval (95%CI) of overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), treatment-related adverse events (TRAEs), and TRAEs ≥ 3 reported in the literature. Results Six articles and a total of 1968 patients were finally included in this analysis. The PFS, ORR, DCR of the treatment group were significantly higher than that of the control group. The TRAEs ≥ 3 of the treatment group were significantly lower than that of the control group. Nonetheless it is no significant difference in TRAEs among these trials. Conclusion The third-generation EGFR-TKIs is effective and safe in the treatment of patients with NSCLC. Although the number of articles included in this article is limited, according to the search results, a large number of relevant trials are ongoing. Therefore, we look forward to the results of related trials, so that the third-generation EGFR-TKIs can be widely used and cure more patients.