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Review

Risk of selected gastrointestinal toxicities in patients with advanced non-small cell lung cancer receiving erlotinib: a systematic review and meta-analysis

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Abstract

We performed a meta-analysis of diarrhea and stomatitis associated with erlotinib use in patients with advanced non-small cell lung cancer. Eligible studies included randomized trials of patients with non-small cell lung cancer on erlotinib describing events of diarrhea and stomatitis. A total of 19 clinical trials including 7524 patients were considered eligible for the meta-analysis. The relative risk of all-grade diarrhea and stomatitis were 2.96 (95% CI: 2.31–3.8; p < 0.00001), 3.62 (95% CI: 2.43–5.39; p = 0.00001), respectively, whereas the relative risk of high-grade diarrhea and stomatitis were 4.65 (95% CI: 3.30–6.55; p < 0.00001), 2.63 (95% CI: 0.83–8.27; p = 0.1), respectively. Our meta-analysis has demonstrated that regimens containing erlotinib for the treatment of advanced non-small cell lung cancer are associated with a significantly increased risk of all-grade diarrhea, stomatitis and high-grade diarrhea. Close clinical monitoring is required when using and administering this drug.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues
  • A systematic review and meta-analysis of diarrhea and stomatitis associated with erlotinib use in patients with advanced non-small cell lung cancer.

  • Eligible studies included randomized trials of patients with non-small cell lung cancer on erlotinib describing events of diarrhea and stomatitis.

  • A total of 19 clinical trials including 7524 patients were considered eligible for the meta-analysis.

  • The RR of all-grade diarrhea and stomatitis were 2.96 (95% CI: 2.31–3.8; p < 0.00001), 3.62 (95% CI: 2.43–5.39; p = 0.00001), respectively, whereas the RR of high-grade diarrhea and stomatitis were 4.65 (95% CI: 3.30–6.55; p < 0.00001), 2.63 (95% CI: 0.83–8.27; p = 0.1), respectively.

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