Skin rash could predict the response to EGFR tyrosine kinase inhibitor and the prognosis for patients with non-small cell lung cancer: a systematic review and meta-analysis
The aim of this study was to assess the role of skin rash in predicting the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and the prognosis of patients with non-small cell lung cancer (NSCLC). We systematically searched for eligible articles investigating the as...
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description | The aim of this study was to assess the role of skin rash in predicting the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and the prognosis of patients with non-small cell lung cancer (NSCLC).
We systematically searched for eligible articles investigating the association between rash and the efficacy of EGFR-TKIs and the prognosis of patients with NSCLC. The summary risk ratio (RR) and hazard ratio (HR) were calculated using meta-analysis.
We identified 33 eligible trials involving 6,798 patients. We used two different standards to group the patients [standard 1: rash vs. no rash, standard 2: rash (≥ stage 2) vs. rash (stage 0, 1)]. For standard 1, the objective response rate (ORR) and disease control rate (DCR) of the rash group were significantly higher than the no rash group [RR = 3.28; 95% CI: 2.41-4.47(corrected RR = 2.225, 95% CI: 1.658-2.986); RR = 1.96, 95% CI: 1.58-2.43]. The same results were observed for standard 2. For standards 1 and 2, the progression-free survival (PFS) (HR = 0.45, 95% CI: 0.37-0.53; HR = 0.57, 95% CI: 0.50-0.65) and overall survival (OS) (HR = 0.40, 95% CI: 0.28-0.52; HR = 0.53, 95% CI: 0.35-0.71) of the rash group were significantly longer than the control group, and the same results were observed in the subgroup analysis.
skin rash after EGFR-TKI treatment may be an efficient clinical marker for predicting the response of patients with NSCLC to EGFR-TKIs. Furthermore, skin rash is also the prognostic factor of patients with NSCLC. Patients with skin rash have a longer PFS and OS. |
doi_str_mv | 10.1371/journal.pone.0055128 |
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We systematically searched for eligible articles investigating the association between rash and the efficacy of EGFR-TKIs and the prognosis of patients with NSCLC. The summary risk ratio (RR) and hazard ratio (HR) were calculated using meta-analysis.
We identified 33 eligible trials involving 6,798 patients. We used two different standards to group the patients [standard 1: rash vs. no rash, standard 2: rash (≥ stage 2) vs. rash (stage 0, 1)]. For standard 1, the objective response rate (ORR) and disease control rate (DCR) of the rash group were significantly higher than the no rash group [RR = 3.28; 95% CI: 2.41-4.47(corrected RR = 2.225, 95% CI: 1.658-2.986); RR = 1.96, 95% CI: 1.58-2.43]. The same results were observed for standard 2. For standards 1 and 2, the progression-free survival (PFS) (HR = 0.45, 95% CI: 0.37-0.53; HR = 0.57, 95% CI: 0.50-0.65) and overall survival (OS) (HR = 0.40, 95% CI: 0.28-0.52; HR = 0.53, 95% CI: 0.35-0.71) of the rash group were significantly longer than the control group, and the same results were observed in the subgroup analysis.
skin rash after EGFR-TKI treatment may be an efficient clinical marker for predicting the response of patients with NSCLC to EGFR-TKIs. Furthermore, skin rash is also the prognostic factor of patients with NSCLC. Patients with skin rash have a longer PFS and OS.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0055128</identifier><identifier>PMID: 23383079</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Cancer ; Cancer therapies ; Carcinoma, Non-Small-Cell Lung - diagnosis ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Chemotherapy ; Clinical trials ; Disease control ; Enzyme inhibitors ; Epidermal growth factor ; Epidermal growth factor receptors ; Epidermal growth factors ; Exanthema ; Exanthema - chemically induced ; Geriatrics ; Hospitals ; Humans ; Lung cancer ; Lung diseases ; Lung Neoplasms - diagnosis ; Lung Neoplasms - drug therapy ; Medical ethics ; Medical prognosis ; Medical research ; Medicine ; Meta-analysis ; Mutation ; Non-small cell lung cancer ; Non-small cell lung carcinoma ; Oncology ; Patients ; Phenols (Class of compounds) ; Prognosis ; Protein Kinase Inhibitors - adverse effects ; Protein Kinase Inhibitors - pharmacology ; Protein Kinase Inhibitors - therapeutic use ; Protein-tyrosine kinase receptors ; Quality of life ; Rash ; Receptor, Epidermal Growth Factor - antagonists & inhibitors ; Rodents ; Skin ; Small cell lung cancer ; Studies ; Survival ; Systematic review ; Treatment Outcome ; Tyrosine</subject><ispartof>PloS one, 2013-01, Vol.8 (1), p.e55128</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 Liu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Liu et al 2013 Liu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-932a06efcda8bb62a5ebb1870fe941ab97ad829266806dd4bf601fa7d42fbf1e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559430/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559430/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23383079$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Hong-bing</creatorcontrib><creatorcontrib>Wu, Ying</creatorcontrib><creatorcontrib>Lv, Tang-feng</creatorcontrib><creatorcontrib>Yao, Yan-wen</creatorcontrib><creatorcontrib>Xiao, Yong-ying</creatorcontrib><creatorcontrib>Yuan, Dong-mei</creatorcontrib><creatorcontrib>Song, Yong</creatorcontrib><title>Skin rash could predict the response to EGFR tyrosine kinase inhibitor and the prognosis for patients with non-small cell lung cancer: a systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The aim of this study was to assess the role of skin rash in predicting the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and the prognosis of patients with non-small cell lung cancer (NSCLC).
We systematically searched for eligible articles investigating the association between rash and the efficacy of EGFR-TKIs and the prognosis of patients with NSCLC. The summary risk ratio (RR) and hazard ratio (HR) were calculated using meta-analysis.
We identified 33 eligible trials involving 6,798 patients. We used two different standards to group the patients [standard 1: rash vs. no rash, standard 2: rash (≥ stage 2) vs. rash (stage 0, 1)]. For standard 1, the objective response rate (ORR) and disease control rate (DCR) of the rash group were significantly higher than the no rash group [RR = 3.28; 95% CI: 2.41-4.47(corrected RR = 2.225, 95% CI: 1.658-2.986); RR = 1.96, 95% CI: 1.58-2.43]. The same results were observed for standard 2. For standards 1 and 2, the progression-free survival (PFS) (HR = 0.45, 95% CI: 0.37-0.53; HR = 0.57, 95% CI: 0.50-0.65) and overall survival (OS) (HR = 0.40, 95% CI: 0.28-0.52; HR = 0.53, 95% CI: 0.35-0.71) of the rash group were significantly longer than the control group, and the same results were observed in the subgroup analysis.
skin rash after EGFR-TKI treatment may be an efficient clinical marker for predicting the response of patients with NSCLC to EGFR-TKIs. Furthermore, skin rash is also the prognostic factor of patients with NSCLC. Patients with skin rash have a longer PFS and OS.</description><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Carcinoma, Non-Small-Cell Lung - diagnosis</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Disease control</subject><subject>Enzyme inhibitors</subject><subject>Epidermal growth factor</subject><subject>Epidermal growth factor receptors</subject><subject>Epidermal growth factors</subject><subject>Exanthema</subject><subject>Exanthema - chemically induced</subject><subject>Geriatrics</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Lung Neoplasms - diagnosis</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Medical ethics</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Meta-analysis</subject><subject>Mutation</subject><subject>Non-small cell lung cancer</subject><subject>Non-small cell lung carcinoma</subject><subject>Oncology</subject><subject>Patients</subject><subject>Phenols (Class of compounds)</subject><subject>Prognosis</subject><subject>Protein Kinase Inhibitors - adverse effects</subject><subject>Protein Kinase Inhibitors - pharmacology</subject><subject>Protein Kinase Inhibitors - therapeutic use</subject><subject>Protein-tyrosine kinase receptors</subject><subject>Quality of life</subject><subject>Rash</subject><subject>Receptor, Epidermal Growth Factor - antagonists & inhibitors</subject><subject>Rodents</subject><subject>Skin</subject><subject>Small cell lung cancer</subject><subject>Studies</subject><subject>Survival</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><subject>Tyrosine</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk2trFDEUhgdRbK3-A9GAIPhh12QyOxc_CKW0daFQaNWv4Uwm2ck6k4xJpnX_kz_Ss5eWXVCQgZlw5nnfcyEnSV4zOmW8YB-XbvQWuungrJpSOpuxtHySHLOKp5M8pfzp3vkoeRHCEiFe5vnz5CjlvOS0qI6T37c_jCUeQkukG7uGDF41RkYSW0W8CugeFImOnF9e3JC48i4YqwiKAOPGtqY20XkCttlIBu8WFplANEYHiEbZGMi9iS2xzk5CD11HpMJXN9oFkWCl8p8IkLAKUfUokJj3zqj7jWevIkwA-1yh58vkmYYuqFe770ny7eL869mXydX15fzs9Goi8yqNE-waaK60bKCs6zyFmaprVhZUqypjUFcFNGVapXle0rxpslrnlGkomizVtWaKnyRvt75D54LYDToIxtOiKipW5kjMt0TjYCkGb3rwK-HAiE3A-YUAj610SlSlnuWMYylpkak6A1oDppE1bUADpej1eZdtrHvVSByYh-7A9PCPNa1YuDvBZ7Mq42uDdzsD736OKsR_lLyjFoBVGasdmsneBClOs6KoeFGwNTX9C4VPo3oj8appg_EDwYcDATJR_YoLGEMQ89ub_2evvx-y7_fYVkEX2-C6MRq8kYdgtgUl3s3glX6cHKNivSkP0xDrTRG7TUHZm_2pP4oeVoP_ARuKE4E</recordid><startdate>20130130</startdate><enddate>20130130</enddate><creator>Liu, Hong-bing</creator><creator>Wu, Ying</creator><creator>Lv, Tang-feng</creator><creator>Yao, Yan-wen</creator><creator>Xiao, Yong-ying</creator><creator>Yuan, Dong-mei</creator><creator>Song, Yong</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130130</creationdate><title>Skin rash could predict the response to EGFR tyrosine kinase inhibitor and the prognosis for patients with non-small cell lung cancer: a systematic review and meta-analysis</title><author>Liu, Hong-bing ; Wu, Ying ; Lv, Tang-feng ; Yao, Yan-wen ; Xiao, Yong-ying ; Yuan, Dong-mei ; Song, Yong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-932a06efcda8bb62a5ebb1870fe941ab97ad829266806dd4bf601fa7d42fbf1e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Carcinoma, Non-Small-Cell Lung - diagnosis</topic><topic>Carcinoma, Non-Small-Cell Lung - drug therapy</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Disease control</topic><topic>Enzyme inhibitors</topic><topic>Epidermal growth factor</topic><topic>Epidermal growth factor receptors</topic><topic>Epidermal growth factors</topic><topic>Exanthema</topic><topic>Exanthema - chemically induced</topic><topic>Geriatrics</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Lung cancer</topic><topic>Lung diseases</topic><topic>Lung Neoplasms - diagnosis</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Medical ethics</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Meta-analysis</topic><topic>Mutation</topic><topic>Non-small cell lung cancer</topic><topic>Non-small cell lung carcinoma</topic><topic>Oncology</topic><topic>Patients</topic><topic>Phenols (Class of compounds)</topic><topic>Prognosis</topic><topic>Protein Kinase Inhibitors - adverse effects</topic><topic>Protein Kinase Inhibitors - pharmacology</topic><topic>Protein Kinase Inhibitors - therapeutic use</topic><topic>Protein-tyrosine kinase receptors</topic><topic>Quality of life</topic><topic>Rash</topic><topic>Receptor, Epidermal Growth Factor - antagonists & inhibitors</topic><topic>Rodents</topic><topic>Skin</topic><topic>Small cell lung cancer</topic><topic>Studies</topic><topic>Survival</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><topic>Tyrosine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Hong-bing</creatorcontrib><creatorcontrib>Wu, Ying</creatorcontrib><creatorcontrib>Lv, Tang-feng</creatorcontrib><creatorcontrib>Yao, Yan-wen</creatorcontrib><creatorcontrib>Xiao, Yong-ying</creatorcontrib><creatorcontrib>Yuan, Dong-mei</creatorcontrib><creatorcontrib>Song, Yong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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We systematically searched for eligible articles investigating the association between rash and the efficacy of EGFR-TKIs and the prognosis of patients with NSCLC. The summary risk ratio (RR) and hazard ratio (HR) were calculated using meta-analysis.
We identified 33 eligible trials involving 6,798 patients. We used two different standards to group the patients [standard 1: rash vs. no rash, standard 2: rash (≥ stage 2) vs. rash (stage 0, 1)]. For standard 1, the objective response rate (ORR) and disease control rate (DCR) of the rash group were significantly higher than the no rash group [RR = 3.28; 95% CI: 2.41-4.47(corrected RR = 2.225, 95% CI: 1.658-2.986); RR = 1.96, 95% CI: 1.58-2.43]. The same results were observed for standard 2. For standards 1 and 2, the progression-free survival (PFS) (HR = 0.45, 95% CI: 0.37-0.53; HR = 0.57, 95% CI: 0.50-0.65) and overall survival (OS) (HR = 0.40, 95% CI: 0.28-0.52; HR = 0.53, 95% CI: 0.35-0.71) of the rash group were significantly longer than the control group, and the same results were observed in the subgroup analysis.
skin rash after EGFR-TKI treatment may be an efficient clinical marker for predicting the response of patients with NSCLC to EGFR-TKIs. Furthermore, skin rash is also the prognostic factor of patients with NSCLC. Patients with skin rash have a longer PFS and OS.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23383079</pmid><doi>10.1371/journal.pone.0055128</doi><tpages>e55128</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Analysis Cancer Cancer therapies Carcinoma, Non-Small-Cell Lung - diagnosis Carcinoma, Non-Small-Cell Lung - drug therapy Chemotherapy Clinical trials Disease control Enzyme inhibitors Epidermal growth factor Epidermal growth factor receptors Epidermal growth factors Exanthema Exanthema - chemically induced Geriatrics Hospitals Humans Lung cancer Lung diseases Lung Neoplasms - diagnosis Lung Neoplasms - drug therapy Medical ethics Medical prognosis Medical research Medicine Meta-analysis Mutation Non-small cell lung cancer Non-small cell lung carcinoma Oncology Patients Phenols (Class of compounds) Prognosis Protein Kinase Inhibitors - adverse effects Protein Kinase Inhibitors - pharmacology Protein Kinase Inhibitors - therapeutic use Protein-tyrosine kinase receptors Quality of life Rash Receptor, Epidermal Growth Factor - antagonists & inhibitors Rodents Skin Small cell lung cancer Studies Survival Systematic review Treatment Outcome Tyrosine |
title | Skin rash could predict the response to EGFR tyrosine kinase inhibitor and the prognosis for patients with non-small cell lung cancer: a systematic review and meta-analysis |
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