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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2.	占美, 徐珽, 吳逢波, 等. 酪氨酸激酶抑制劑聯合化療治療非小細胞肺癌的系統評價. 中國醫院藥學雜志, 2014, 34(17): 1489-1495.
3.	趙靜, 張坤, 張力予, 等. 克唑替尼治療 ALK 陽性晚期非小細胞肺癌患者的療效觀察. 中國肺癌雜志, 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.
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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, 喬蕾, 孟春, 等. 克唑替尼治療 EML4-ALK 陽性晚期非小細胞肺癌的臨床療效觀察. 中國實用醫藥, 2014, 9(24): 157-158.
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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.	鄭明英, 張力. 克唑替尼治療 ALK 融合基因陽性的晚期非小細胞肺癌患者的療效分析. 癌癥進展, 2015, 13(1): 83-86.
14.	劉雨桃, 王子平, 胡興勝, 等. 克唑替尼對 ALK 融合基因陽性腦轉移肺癌患者的療效分析. 中國新藥雜志, 2015, 24(15): 1760-1764.
15.	黃偉, 王琳, 秦叔逵, 等. 克唑替尼治療 ALK 陽性非小細胞肺癌腦轉移的療效觀察. 中國癌癥雜志, 2015, 25(6): 467-471.
16.	蔣燕, 孫曉云. 克唑替尼治療非小細胞肺癌的護理. 中國保健營養: 下旬刊, 2014, 24(2): 933-934.
17.	武勇輝, 張健, 吳偉彬. 克唑替尼治療 EML4-ALK 陽性晚期非小細胞肺癌化療后進展 1 例并文獻復習. 大家健康: 下旬版, 2015, 9(5): 156-157.
18.	王偉蘭, 張超, 朱曼. 從一例肺癌伴疼痛患者探討克唑替尼與阿片類止痛藥的相互作用//2013 年中國藥學大會暨第十三屆中國藥師周論文集. 南寧, 2013: 1-6.
19.	喬昱, 馬家芳, 張萍, 等. Alk 陽性肺腺癌卵巢轉移 1 例報道. 腫瘤, 2015, 35(7): 806-809.
20.	穆晶, 吳衛華, 蔡毅然, 等. ALK 陽性并克唑替尼治療有效肺鱗狀細胞癌臨床病理分析. 臨床和實驗醫學雜志, 2015, 14(11): 919-922.
21.	陳雪姣, 王朝杰, 白冰, 等. 克唑替尼治療 1 例晚期 ALK 陰性非小細胞肺癌的療效分析及文獻復習. 分子影像學雜志, 2015, 38(3): 311-312.

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, 吳逢波, 等. 酪氨酸激酶抑制劑聯合化療治療非小細胞肺癌的系統評價. 中國醫院藥學雜志, 2014, 34(17): 1489-1495.
3. 趙靜, 張坤, 張力予, 等. 克唑替尼治療 ALK 陽性晚期非小細胞肺癌患者的療效觀察. 中國肺癌雜志, 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, 喬蕾, 孟春, 等. 克唑替尼治療 EML4-ALK 陽性晚期非小細胞肺癌的臨床療效觀察. 中國實用醫藥, 2014, 9(24): 157-158.
11. 吳璇, 李建雄. 克唑替尼治療 EML4-ALK 重排陽性患者的臨床療效. 南方醫科大學學報, 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. 鄭明英, 張力. 克唑替尼治療 ALK 融合基因陽性的晚期非小細胞肺癌患者的療效分析. 癌癥進展, 2015, 13(1): 83-86.
14. 劉雨桃, 王子平, 胡興勝, 等. 克唑替尼對 ALK 融合基因陽性腦轉移肺癌患者的療效分析. 中國新藥雜志, 2015, 24(15): 1760-1764.
15. 黃偉, 王琳, 秦叔逵, 等. 克唑替尼治療 ALK 陽性非小細胞肺癌腦轉移的療效觀察. 中國癌癥雜志, 2015, 25(6): 467-471.
16. 蔣燕, 孫曉云. 克唑替尼治療非小細胞肺癌的護理. 中國保健營養: 下旬刊, 2014, 24(2): 933-934.
17. 武勇輝, 張健, 吳偉彬. 克唑替尼治療 EML4-ALK 陽性晚期非小細胞肺癌化療后進展 1 例并文獻復習. 大家健康: 下旬版, 2015, 9(5): 156-157.
18. 王偉蘭, 張超, 朱曼. 從一例肺癌伴疼痛患者探討克唑替尼與阿片類止痛藥的相互作用//2013 年中國藥學大會暨第十三屆中國藥師周論文集. 南寧, 2013: 1-6.
19. 喬昱, 馬家芳, 張萍, 等. Alk 陽性肺腺癌卵巢轉移 1 例報道. 腫瘤, 2015, 35(7): 806-809.
20. 穆晶, 吳衛華, 蔡毅然, 等. ALK 陽性并克唑替尼治療有效肺鱗狀細胞癌臨床病理分析. 臨床和實驗醫學雜志, 2015, 14(11): 919-922.
21. 陳雪姣, 王朝杰, 白冰, 等. 克唑替尼治療 1 例晚期 ALK 陰性非小細胞肺癌的療效分析及文獻復習. 分子影像學雜志, 2015, 38(3): 311-312.

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