A systematic review and meta-analysis on effectiveness and safety of traditional Chinese medicine combined with EGFR-TKIs in treating advanced non-small cell lung cancer. A protocol for systematic review and meta analysis

IntroductionEGFR-TKIs have been shown in multiple clinical trials to be effective in first-line therapy, but acquired resistance is inevitable regardless of the recent effect. EGFR-TKIs combined with TCM comprehensive therapy have shown unique effects in clinical randomized trials to increase the efficacy of radiotherapy and chemotherapy and gene-targeted drugs, reduce their adverse reactions, reduce the chance of recurrence and metastasis, enhance the immune recognition and killing of lung cancer cells, and reverse the multi-drug resistance of lung cancer cells. Therefore, our study aims to clarify the clinical efficacy, safety and benefit of EGFR-TKIs combined with TCM in the treatment of advanced non-small cell lung cancer. Methods and AnalysisWe will search four international electronic databases (PubMed, Cochrane Library, EMBASE and Web of Science) and four Chinese electronic databases (CNKI, VIP, WanFang, China Biology Medicine) to retrieve relevant literature. We only included studies from launch until publication in May 2022. The primary outcomes will include the Response Evaluation Criteria in Solid Tumours progression-free survival and effectiveness rate Secondary outcomes will include Karnofsky functional status scale, 1-year survival rate, and grading scale for common toxicities of anticancer drugs(WHO). Two reviewers will conduct independent research selection, data extraction, data synthesis and quality assessment. The assessment of bias risk and data synthesis will be conducted using Review Manager 5.3 software. Improved Jadad scale will be used to evaluate the quality of evidence. Ethics and DisseminationBecause this systematic review will be conducted based on published research, there is no ethical approval requirement. The findings of this systematic review will be published in a peerreviewed journal.