Fatigue with epidermal growth factor receptor tyrosine kinase inhibitors in cancer patients: A meta-analysis of randomized controlled trials

We conducted this systematic review to fully investigate the fatigue of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in cancer patients. The approved and clinical used EGFR-TKIs were selected for the present meta-analysis. The relevant studies of the randomized controlled trials (RCTs) in cancer patients treated with EGFR-TKIs were retrieved and the systematic evaluation was conducted. EMBASE, MEDLINE, and PubMed were searched for articles published till July 2017. Eighteen randomized controlled trials and 14088 patients were included. The current analysis suggested that the use of EGFR-TKIs increased the risk of all-grade fatigue (1.26(sic)95%CI, 1.17-1.36(sic)p < 0.00001) and high-grade (>= grade 3) fatigue (1.47(sic)95%CI, 1.22-1.78(sic)p < 0.0001). On subgroup analysis, the RR of high-grade fatigue varies significantly according to drug type, cancer type, treatment line, and treatment duration. The available data suggested that the use of EGFR-TKIs is associated with a significantly increased risk of fatigue in cancer patients.