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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Veröffentlicht in:PloS one 2013-01, Vol.8 (1), p.e55128
Hauptverfasser: Liu, Hong-bing, Wu, Ying, Lv, Tang-feng, Yao, Yan-wen, Xiao, Yong-ying, Yuan, Dong-mei, Song, Yong
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container_title PloS one
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creator Liu, Hong-bing
Wu, Ying
Lv, Tang-feng
Yao, Yan-wen
Xiao, Yong-ying
Yuan, Dong-mei
Song, Yong
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 &amp; 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. 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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><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 &amp; 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 ; 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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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