Efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) monotherapy for advanced EGFR-mutated non-small cell lung cancer: systematic review and meta-analysis
journal contributionposted on 2023-08-30, 18:20 authored by Hyojeong Lee, Gwang Hun Jeong, Han Li, Min Seo Kim, Jae Seok Kim, Se Jin Park, Young Joo Han, Keum Hwa Lee, Andreas Kronbichler, Sung Hwi Hong, Ramy A. Ghayda, Claudio Luchini, Alessia Nottegar, Ai Koyanagi, Lee Smith, Louis Jacob, Elena Dragioti, Joaquim Radua, Sarah Cargnin, Salvatore Terrazzino, Trevor Thompson, Dong Keon Yon, Seung Won Lee, Jee Myung Yang, Paul Wasuwanich, Jae Il Shin, Gabriele Gamerith
OBJECTIVE: It is controversial whether there is efficacy or safety benefit of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in advanced EGFR-mutated non-small cell lung cancer (NSCLC) compared to standard chemotherapy. We aim to assess the efficacy and safety of EGFR-TKIs compared to other chemotherapeutics in EGFR-mutated NSCLC. MATERIALS AND METHODS: Up to April 27th, 2020, PubMed, Embase, Medline, Scopus, Cochrane library, and ClinicalTrials.gov were searched for articles or trials meeting the inclusion criteria. After filtering, 230 eligible studies were initially identified. Data extraction followed PRISMA and included outcomes were progression-free survival (PFS), overall survival (OS), and severe adverse events (SAEs). Direct and indirect meta-analyses were generated in the context of log-linear mixed-effects models, with fixed effects for each relative comparison and random effects for each study. RESULTS: The results showed that EGFR-TKI therapy had improved PFS with a hazard ratio (HR) of 0.40 (95% CI: 0.36-0.44, p<0.001) compared to standard chemotherapy. Nevertheless, the EGFR-TKIs showed no benefit on OS (HR: 0.96, 95% CI: 0.83-1.10, p=0.556). In the analysis of adverse events, EGFR-TKIs had fewer SAEs than standard chemotherapy (HR: 0.29, 95% CI: 0.26-0.33, p<0.001). CONCLUSIONS: Our systemic review indicates that EGFR-TKI therapy has improved PFS, and reduced SAEs compared to standard chemotherapy in advanced EGFR-mutated NSCLC.
Publication titleEuropean Review for Medical and Pharmacological Sciences
- Accepted version