Object. This study is aimed at evaluating the efficacy and safety of pemetrexed and gefitinib in the treatment of non-small-cell lung cancer (NSCLC). Methods. Databases, including PubMed, the Cochrane Library, Embase, CNKI, and Web of Science, were applied to search for randomized controlled trials (RCTs) about the use of pemetrexed and gefitinib in the second-line treatment of locally advanced and metastatic NSCLC from database foundation to April 2020. Meta-analysis was conducted using the RevMan 5.3 software. Primary outcomes included progression-free survival (PFS) and overall survival (OS), and secondary outcomes included objective response rate (ORR), disease control rate (DCR), and all grades of drug-related adverse events (AEs). Results. Totally, 14 RCTs and 1,334 patients were involved in the study. The results of meta-analysis showed that compared with pemetrexed, gefitinib was not superior in improving ORR (), DCR (), PFS (), and OS (). Subgroup analysis showed that in patients with mutant EGFR () and wild-type EGFR (), both pemetrexed and gefitinib produced a similar effect on PFS. In terms of safety, the incidence of rash () and diarrhea () in the gefitinib group was significantly higher than those in the pemetrexed group, while the occurrence of neutropenia () and fatigue () was significantly lower. Conclusion. Gefitinib and pemetrexed showed similar efficacy and safety, regardless of the type of EGFR. Both gefitinib and pemetrexed can be used as conventional drugs for the second-line treatment of locally advanced and metastatic NSCLC.

中文翻译：

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培美曲塞和吉非替尼治疗非小细胞肺癌的疗效和安全性的荟萃分析

对象。这项研究旨在评估培美曲塞和吉非替尼在治疗非小细胞肺癌（NSCLC）中的疗效和安全性。方法。应用包括PubMed，Cochrane库，Embase，CNKI和Web of Science在内的数据库，从数据库中搜索有关培美曲塞和吉非替尼用于局部晚期转移性NSCLC的二线治疗的随机对照试验（RCT）。基金会直到2020年4月。使用RevMan 5.3软件进行了荟萃分析。主要结局包括无进展生存期（PFS）和总体生存期（OS），次要结局包括客观缓解率（ORR），疾病控制率（DCR）和所有级别的药物相关不良事件（AEs）。结果。该研究共涉及14个RCT和1,334例患者。荟萃分析的结果表明，与培美曲塞相比，吉非替尼在改善ORR方面并不优越（）， DCR（）， PFS（）和操作系统（）。亚组分析显示，在突变型EGFR（）和野生型EGFR（），培美曲塞和吉非替尼对PFS产生相似的作用。就安全性而言，皮疹的发生率（）和腹泻（）在吉非替尼组中显着高于培美曲塞组，而中性粒细胞减少症（）和疲劳（）明显更低。结论。吉非替尼和培美曲塞显示出相似的疗效和安全性，与EGFR的类型无关。吉非替尼和培美曲塞均可作为常规药物用于二线治疗局部晚期和转移性非小细胞肺癌。