Adjuvant EGFR tyrosine kinase inhibitors for patients with resected EGFR-mutated non-small-cell lung cancer: a network meta-analysis

被引:2
作者
Tian, Wentao [1 ,2 ]
Tan, Nuopei [3 ]
Ke, Jiawen [3 ]
Zou, Ji'an [1 ,2 ]
Liu, Xiaohan [1 ]
Pan, Yue [1 ]
Zeng, Yue [1 ]
Peng, Yurong [1 ]
Wu, Fang [1 ,4 ,5 ,6 ]
机构
[1] Cent South Univ, Xiangya Hosp 2, Dept Oncol, Changsha 410011, Hunan, Peoples R China
[2] Cent South Univ, Xiangya Sch Med, Changsha 410078, Hunan, Peoples R China
[3] Cent South Univ, Xiangya Sch Publ Hlth, Changsha 410005, Hunan, Peoples R China
[4] Hunan Canc Megadata Intelligent Applicat & Engn R, Changsha 410011, Hunan, Peoples R China
[5] Cent South Univ, Xiangya Hosp 2, Hunan Key Lab Tumor Models & Individualized Med, Changsha 410011, Hunan, Peoples R China
[6] Cent South Univ, Xiangya Hosp 2, Hunan Key Lab Early Diag & Precis Therapy Lung Ca, Changsha 410011, Hunan, Peoples R China
关键词
adjuvant therapy; disease-free survival; EGFR; erlotinib; gefitinib; icotinib; network meta-analysis; non-small-cell lung cancer; osimertinib; tyrosine kinase inhibitor; SYSTEMIC THERAPY; DOUBLE-BLIND; SINGLE-ARM; OPEN-LABEL; CHEMOTHERAPY; GEFITINIB; IIIA; MUTATIONS; ICOTINIB; OSIMERTINIB;
D O I
10.2217/fon-2021-1614
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aim: To investigate the efficacy and safety of adjuvant EGFR tyrosine kinase inhibitors for resected EGFR-mutated non-small-cell lung cancer. Materials & methods: Eligible phase II/III randomized controlled trials were included for the network meta-analyses (PROSPERO CRD42021275150). Results: Nine records and 831 patients were involved. Adjuvant chemotherapy followed with osimertinib significantly prolonged disease-free survival compared with chemotherapy (hazard ratio [HR]: 0.2; 95% CI: 0.14-0.29), chemotherapy followed with erlotinib (HR: 0.33; 95% CI: 0.18-0.6), chemotherapy followed with gefitinib (HR: 0.36; 95% CI: 0.16-0.82), gefitinib (HR: 0.26; 95% CI: 0.17-0.41) and icotinib (HR: 0.56; 95% CI: 0.3-0.98). Icotinib was the least likely to cause grade >= 3 adverse events. Conclusion: Chemotherapy followed with osimertinib brings about the best disease-free survival. Icotinib monotherapy shows the best safety. Plain language summary Patients with early-stage non-small-cell lung cancer have about a one-in-five chance of cancer recurrence, even after complete resection. Using agents targeting EGFR, known as adjuvant EGFR tyrosine kinase inhibitors, after surgery is an effective way for patients with EGFR-mutated non-small-cell lung cancer to prevent recurrence. However, the optimal agent with favorable efficacy and safety is yet to be determined. This study showed that adjuvant chemotherapy followed with osimertinib had the best efficacy, while adjuvant icotinib monotherapy had the best safety.
引用
收藏
页码:2695 / 2708
页数:14
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