The safety and efficacy of tyrosine kinase inhibitors against EGFR in patients with glioma; A systematic review, meta-analysis, and sub-group analysis on glioblastoma.

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Tác giả: Muhammad Hussain Ahmadvand, Aliakbar Aliasgary, Ali Allahdadi, Zahra Ardestani, Pouria Delbari, Mohammad Shahir Eftekhar, Mohammad Amin Habibi, Bardia Hajikarimloo, Baran Mehdizadeh, Mohammad Sina Mirjani, Ibrahim Mohammadzadeh, Romina Hamidi Rad, Saba Sabet, Amir Hessam Zare

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: Scotland : Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 739038

BACKGROUND: Gliomas, particularly glioblastoma (GBM), remain challenging to treat and have a poor prognosis. Tyrosine kinase inhibitors (TKIs) targeting EGFR have shown promise, but their efficacy in gliomas is not well established. This study aimed to systematically review and meta-analyze the safety and efficacy of EGFR TKIs in patients with glioma, specifically for primary and recurrent GBM. METHODS: A comprehensive literature search was conducted across PubMed, Embase, Scopus, and Web of Science up to January 1, 2024. Randomized controlled trials and observational studies evaluating TKIs in glioma patients were included. Primary outcomes were overall survival (OS), progression-free survival (PFS), and adverse events. A random-effects meta-analysis was performed to pool results. All statistical analysis was performed using STATA v.17. RESULTS: A total of 2,424 patients from 51 studies were included. The pooled mean OS was 12.68 months (95 % CI: 6.29-19.08) with 1-year and 2-year OS rates of 43 % (95 % CI: 34 %-52 %) and 14 % (95 % CI: 8 %-20 %), respectively. The mean PFS was 9.61 months (95 % CI: 4.83-14.38). The overall response rate was 19 % (95 % CI: 1 %-36 %). Grade ≥ 3 adverse events occurred in 35 % of patients (95 % CI: 13 %-57 %). Subgroup analyses revealed that combination therapies outperformed TKI monotherapy, and some newer TKIs, like vandetanib, showed improved efficacy. CONCLUSIONS: TKIs demonstrate modest but meaningful benefits in glioma treatment, particularly when combined with other therapies. While initial survival improvements are observed, long-term outcomes remain challenging. Further research is needed to develop more potent, brain-penetrant TKIs and optimize combination strategies to improve outcomes in glioma patients.
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