title: Incidence and risk of infections associated with EGFR-TKIs in advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized controlled trials.
abstract: Currently, the overall incidence and risk of infections with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) in non-small-cell lung cancer (NSCLC) patients remained undetermined. We searched Pubmed for related articles published from 1 January 1990 to 31 November 2015. Eligible studies included prospective randomized controlled trials (RCTs) evaluating therapy with or without EGFR-TKIs in patients with NSCLC. Data on infections were extracted. Pooled incidence, Peto odds ratio (Peto OR), and 95% confidence intervals (CIs) were calculated. A total of 17,420 patients from 25 RCTs were included. The use of EGFR-TKIs significantly increased the risk of developing all-grade infections (Peto OR 1.48, 95%CI: 1.12-1.96, p = 0.006) in NSCLC patients, but not for severe (Peto OR 1.26, 95%CI: 0.96-1.67, p = 0.098) and fatal infections (Peto OR 0.81, 95%CI: 0.43-1.53, p = 0.52). Meta-regression indicated the risk of infections tended to increase with the treatment duration of EGFR-TKIs. No publication of bias was detected. In conclusion, the use of EGFR-TKIs significantly increased the risk of developing all-grade infectious events in NSCLC patients, but not for severe and fatal infections. Clinicians should be aware of the risks of infections with the administration of these drugs in these patients.
authors.affiliation: Department of Respiratory Medicine, Beijing Airport Hospital, Shunyi district, Beijing, China.
authors.forename: Yingtian
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Beijing Airport Hospital, Shunyi district, Beijing, China.|Department of Respiratory Medicine, Dongying People's Hospital, Dongying, Shandong, Shandong, China.
authors.forename: Mingzhen
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Beijing Airport Hospital, Shunyi district, Beijing, China.|Department of Respiratory Medicine, Dongying People's Hospital, Dongying, Shandong, Shandong, China.
authors.forename: Qiaoxia
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Respiratory Medicine, Beijing Airport Hospital, Shunyi district, Beijing, China.|Department of Respiratory Medicine, Dongying People's Hospital, Dongying, Shandong, Shandong, China.
authors.forename: Zhiying
authors.initials: Z
authors.lastname: Geng
authors.affiliation: Department of Respiratory Medicine, Beijing Airport Hospital, Shunyi district, Beijing, China.|Department of Respiratory Medicine, Dongying People's Hospital, Dongying, Shandong, Shandong, China.
authors.forename: Mingxiang
authors.initials: M
authors.lastname: Sun
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors
keywords: EGFR-TKIs; erlotinib; gefitinib; infections; non-small-cell lung cancer