Cited by 843Lung Cancer Treatments and MutationsCancer Immunotherapy and BiomarkersLung Cancer Diagnosis and Treatment

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Checkpoint inhibitors in metastatic EGFR-mutated non–small cell lung cancer-a meta-analysis

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Lee, Chee Khoon, Man, Johnathan, Lord, Sally, Links, Matthew, Gebski, Val, Mok, Tony, Yang, James Chih-Hsin·2017·Journal of Thoracic Oncology

DOI 10.1016/j.jtho.2016.10.007

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Abstract

Introduction We performed a meta-analysis to assess the role of immune checkpoint inhibitors as second-line therapy in EGFR-mutant advanced NSCLC.Methods Randomized trials comparing immune checkpoint inhibitors against chemotherapy were identified. We retrieved the hazard ratio (HR) and 95% confidence interval (CI) for overall survival (OS) of the intention-to-treat population and EGFR mutation-defined subgroups. We used the fixed-effects inverse variance-weighted method to pool estimates of treatment efficacy. Statistical tests were two sided.Results In the three included studies that compared immune checkpoint inhibitors (nivolumab [n = 292], pembrolizumab [n = 691], and atezolizumab [n =144]) against docetaxel (n = 776), immune checkpoint inhibitors significantly prolonged OS over that with docetaxel overall (n = 1903, HR = 0.68, 95% CI: 0.61-0.77, p < 0.0001) and in the EGFR wild-type subgroup (n = 1362, HR = 0.66, 95% CI: 0.58-0.76, p < 0.0001) but not in the EGFR-mutant subgroup (n = 186, HR = 1.05, 95% CI: 0.70-1.55, p < 0.81; treatment-mutation interaction p = 0.03).Conclusion In EGFR-mutant advanced NSCLC, immune checkpoint inhibitors do not improve OS over that with docetaxel. Mechanisms of acquired resistance to first-line tyrosine kinase inhibitor therapy should be elucidated to guide selection of second-line treatment for these patients.

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Additional file 6 of Efficacy of immune checkpoint inhibitors in non-small cell lung cancer with NTRK family mutations
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Additional file 5 of Efficacy of immune checkpoint inhibitors in non-small cell lung cancer with NTRK family mutations
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Additional file 6 of Proximity proteome mapping reveals PD-L1-dependent pathways disrupted by anti-PD-L1 antibody specifically in EGFR-mutant lung cancer cells
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Additional file 4 of Efficacy of immune checkpoint inhibitors in non-small cell lung cancer with NTRK family mutations
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Additional file 4 of Proximity proteome mapping reveals PD-L1-dependent pathways disrupted by anti-PD-L1 antibody specifically in EGFR-mutant lung cancer cells
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Additional file 1 of EGFR mutations induce the suppression of CD8+ T cell and anti-PD-1 resistance via ERK1/2-p90RSK-TGF-β axis in non-small cell lung cancer
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Additional file 3 of Efficacy of immune checkpoint inhibitors in non-small cell lung cancer with NTRK family mutations
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Additional file 2 of Reporting of financial conflicts of interest in meta-analyses of drug trials published in high-impact medical journals: comparison of results from 2017 to 2018 and 2009
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Additional file 1 of Reporting of financial conflicts of interest in meta-analyses of drug trials published in high-impact medical journals: comparison of results from 2017 to 2018 and 2009
Benea, C., Turner, K. A., Roseman, M., Bero, L. A., Lexchin, J., Turner, E. H., & Thombs, B. D. (2020) · Figshare · doi:10.6084/m9.figshare.12101838
Additional file 1 of ANK2 as a novel predictive biomarker for immune checkpoint inhibitors and its correlation with antitumor immunity in lung adenocarcinoma
Zhang, W., Shang, X., Liu, N., Ma, X., Yang, R., Xia, H., Zhang, Y., Zheng, Q., Wang, X., & Liu, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26556251

Authors: Lee, C. K., Man, J., Lord, S., Links, M., Gebski, V., Mok, T., & Yang, J. C.-H.
Affiliations: The University of Sydney (AU)
St George Hospital (AU)
Chinese University of Hong Kong (HK)
National Taiwan University (TW)
Corresponding author: Lee, Chee Khoon
ORCID: Lee, Chee Khoon
Man, Johnathan
Links, Matthew
Gebski, Val
Mok, Tony
Yang, James Chih-Hsin
Venue: Journal of Thoracic Oncology
Publisher: Elsevier BV
Published: 2017-02
Volume: 12
Issue: 2
Pages: 403-407
ISSN: 1556-0864 (ISSN-L)
DOI: 10.1016/j.jtho.2016.10.007
OpenAlex: W2538232731
Cited by: 839
References: 15
Citations by year: 2026: 47 · 2025: 61 · 2024: 68 · 2023: 84 · 2022: 93 · 2021: 98 · 2020: 100 · 2019: 100 · 2018: 123 · 2017: 62
FWCI: 85.21
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 365 d)
Locations: Journal of Thoracic Oncology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Keywords: immune checkpoint inhibitors, EGFR-mutant non-small cell lung cancer, second-line therapy, nivolumab, pembrolizumab, atezolizumab, docetaxel, overall survival, advanced non-small cell lung cancer
MeSH terms: Antineoplastic Agents, Carcinoma, Non-Small-Cell Lung, Humans, Immunotherapy, Lung Neoplasms, Mutation, Prognosis, Randomized Controlled Trials as Topic, Cell Cycle Checkpoints, ErbB Receptors

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Checkpoint inhibitors in metastatic EGFR-mutated non–small cell lung cancer-a meta-analysis

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