Treatment outcome of patients with co-existing TB and LC: systematic reviews and meta-analysis

Abstract

Purpose Treatment effect of patients with co-existing tuberculosis (TB) and lung cancer (LC) is still not conclusive. This systematic review and meta-analysis aim to assess treatment regimen, the efficacy and safety of anti-cancer and anti-TB treatment in non-small cell lung cancer (NSCLC) patients with concomitant active TB. Methods A Systematic and comprehensive search was performed in the following databases: PubMed, Embase, and Web of Science, in articles and abstracts published from 1929 to 2022. Eleven articles (involving 809 co-existing TB and LC cases and 10167 LC controls) met the inconclusive criteria. Review Manager version 5.4 software and Stata version 17.0 software were used for this statistical analysis. Results The result of this meta-analysis demonstrates that OS in coexisting pulmonary TB and NSCLC was decreased compared to NSCLC alone (log HR = 1.07, 95% CI = 0.97–1.18, p＜0.001). After removing AEs related to ICI treatment, other AEs of any grade were similar in patients with or without PTB treated with chemotherapy or target drug (log RR = 0.07, 95% CI=-0.04–0.18, p = 0.64, I2 = 0.00%). Timing to anti-cancer therapy: for 39.0% (102/261) of patients, at least 1–4 weeks after the start of anti-TB therapy; for 3.4% (9/261) of patients, at 2 weeks before the start of anti-TB treatment; for 14.6% (38/261) of patients, at received the anti-TB treatment at the same time. Conclusion The result of this meta-analysis demonstrates that OS in coexisting pulmonary TB and NSCLC was decreased compared to NSCLC alone; LC patients with TB receiving first-line chemotherapy or targeted therapy and anti-TB treatment at least 1–4 weeks after the start of anti-TB treatment or at the same time will not increase the incidence of AEs.