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

Graphical abstract Highlights • This meta-analysis provided a comprehensive evaluation of diarrhea in patients with cancers receiving EGFR-TKIs. • Participants assigned to treatment with one of EGFR-TKIs daily. • EGFR-TKIs significantly increase the risk of developing diarrhea in cancer patients. • The risk of all-grade and high-grade diarrhea varies significantly within drug type. • The risk of all-grade diarrhea varies significantly according to tumor type. Abstract We performed an meta-analysis to fully investigate the diarrhea of EGFR-TKIs in cancer patients. 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 August 2017. The relevant RCTs in cancer patients treated with EGFR-TKIs were retrieved and the systematic evaluation was conducted. Twenty-four RCTs and 13,748 patients were included. The current analysis suggested that the use of EGFR-TKIs increased the risk of all-grade diarrhea (RR 3.45; 95%CI, 2.94–4.06; p＜0.00001) and high-grade (≥grade 3) diarrhea (RR 8.22；95%CI, 6.02–11.23; p＜0.00001). On subgroup analysis, the risk of all-grade and high-grade diarrhea varied significantly within drug type. The risk of all-grade diarrhea varied significantly according to cancer type, whereas the risk of high-grade diarrhea did not. The risk of all-grade and high-grade diarrhea did not varied significantly based on treatment line, treatment duration and median age. The available data suggested that the use of EGFR-TKIs is associated with a significantly increased risk of diarrhea in cancer patients. [ABSTRACT FROM AUTHOR]