• An Evaluation of the Safety and Effectiveness of Tyrosine Kinase Inhibitors Targeting EGFR in Glioma Patients: A Comprehensive Systematic Review and Meta-Analysis
  • Mohammad Amin Habibi,1 Muhammad Hussain Ahmadvand,2 Pouria Delbari,3 Mohammad Reza Ahmadi,4,* Mohammad Sina Mirjani,5 Aliakbar Aliasgary,6
    1. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
    2. Medical student at Tehran University of Medical Sciences, Tehran, Iran
    3. Medical student at Tehran University of Medical Sciences, Tehran, Iran
    4. Student Research Committee of Qom University of Medical Sciences, Qom, Iran
    5. Student Research Committee, Qom University of Medical Sciences, Qom, Iran
    6. Student Research Committee of Qom University of Medical Sciences, Qom, Iran


  • Introduction: Gliomas, especially glioblastoma, present significant treatment challenges and are associated with a poor prognosis. Although tyrosine kinase inhibitors (TKIs) that target the epidermal growth factor receptor (EGFR) have shown potential, their effectiveness in gliomas has not been thoroughly validated. This study sought to systematically review and conduct a meta-analysis on the safety and efficacy of TKIs in patients with glioma.
  • Methods: A thorough literature search was performed across databases including PubMed, Embase, Scopus, and Web of Science, concluding on December 26, 2023. The inclusion criteria encompassed randomized controlled trials and observational studies that assessed TKIs in glioma patients. The primary outcomes measured were overall survival (OS), progression-free survival (PFS), and the incidence of adverse events. A random-effects meta-analysis was utilized to aggregate the results.
  • Results: A total of 2,424 patients from various studies were analyzed. The pooled mean OS was determined to be 12.68 months (95% CI: 6.29-19.08), with 1-year and 2-year OS rates of 43% (95% CI: 34%-52%) and 14% (95% CI: 8%-20%), respectively. The mean PFS was recorded at 9.61 months (95% CI: 4.83-14.38). The overall response rate was found to be 19% (95% CI: 1%-36%). Adverse events classified as grade ≥3 were reported in 35% of patients (95% CI: 13%-57%). Subgroup analyses indicated that combination therapies yielded better outcomes compared to TKI monotherapy, with certain newer TKIs, such as vandetanib, demonstrating enhanced efficacy.
  • Conclusion: TKIs offer modest yet significant advantages in the treatment of gliomas, particularly when used in conjunction with other therapeutic modalities. Although initial improvements in survival rates are noted, long-term outcomes continue to pose challenges. Additional research is essential to develop more effective, brain-penetrant TKIs and to refine combination treatment strategies to enhance patient outcomes in glioma cases.
  • Keywords: Glioma, TKI, Tyrosine Kinase Inhibitor, EGFR