Radiotherapy and Receptor Tyrosine Kinase Inhibition for Solid Cancers (ROCKIT): a Meta-Analysis of 13 Studies
A partir d'une revue systématique de la littérature publiée entre 2000 et 2018 (13 études randomisées, 5 678 patients), cette méta-analyse évalue l'intérêt, du point de vue de la survie globale, d'ajouter des inhibiteurs de récepteurs à tyrosine kinase à la radiothérapie chez des patients présentant des tumeurs solides
We hypothesized that the addition of receptor tyrosine kinase inhibitors (RTKi’s) to radiotherapy-based treatment for solid tumors does not increase overall survival but may increase toxicity.PICOS/PRISMA/MOOSE methods were used to identify prospective randomized studies including patients with solid tumor cancers treated with radiotherapy +/- RTKi’s. Extracted variables included use of radiotherapy vs chemoradiotherapy, RTKi type (antibody vs small molecule), outcomes, and toxicities. The primary endpoint was overall survival; the secondary endpoint was grade 3+ toxicity. Random-effects meta-analyses were performed for each outcome measure. All statistical tests were 2-sided.405 total studies met initial search criteria, of which 13 prospective randomized trials of radiotherapy +/- RTKi met inclusion criteria, encompassing 5,678 patients. The trials included cancers of the head and neck (6 trials, 3,295 patients), esophagus (3 trials, 762 patients), lung (2 trials, 550 patients), and brain (2 trials, 1,542 patients). Three studies evaluated a small molecule and radiotherapy in 949 patients, and 10 studies evaluated antibodies and radiotherapy in 4,729 patients. The addition of RTKi’s to radiotherapy-based treatment did not improve overall survival (hazard ratio = 1.02, 95% confidence interval = 0.90 to 1.15; P = .76) but increased toxicity (relative risk = 1.18, 95% confidence interval = 1.06 to 1.33; P = .009).The addition of RTKi’s to radiotherapy does not improve survival and worsens toxicity.
JNCI Cancer Spectrum 2021