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Cited by 101Lung Cancer Treatments and MutationsLung Cancer Diagnosis and TreatmentHER2/EGFR in Cancer Research

Overall survival benefits of first-line EGFR tyrosine kinase inhibitors in EGFR-mutated non-small-cell lung cancers: a systematic review and meta-analysis

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Kuan, Feng-Che, Kuo, Liang-Tseng, Chen, Min-Chi, Yang, Cheng-Ta, Shi, Chung-Sheng, Teng, David, Lee, Kuan-Der·2015·British Journal of Cancer
DOI 10.1038/bjc.2015.356PMC PMC4815883
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Abstract

BACKGROUND: Accumulating data shows that exon 19 deletions and L858R, both activating epidermal growth factor receptor mutations in non-small-cell lung cancers (NSCLCs), are just two different entities in terms of prognosis and treatment response to tyrosine kinase inhibitors (TKIs). METHODS: A systematic review and meta-analysis of randomized controlled trials comparing TKIs with conventional chemotherapy was performed. Eight trials of 1498 patients and five trials of 1279 patients with either exon 19 deletions or L858R were included in the meta-analysis. RESULTS: TKI treatment demonstrated progression-free survival benefit in patients with exon 19 deletions (hazard ratio (HR): 0.27, 95% confidence interval (CI): 0.21-0.35) and L858R (HR: 0.45, 95% CI: 0.35-0.58). Patients with exon 19 deletions had significant overall survival (OS) benefit under TKI treatment (HR: 0.72, 95% CI: 0.60-0.88). Subgroup analyses showed that irreversible TKIs, but not reversible TKIs, had statistically significant OS benefit in these patients (irreversible TKIs, HR: 0.59, 95% CI: 0.47-0.73; reversible TKIs, HR: 0.84, 95% CI: 0.69-1.02). Patients with L858R demonstrated no OS benefit under first-line TKI use (HR: 1.15, 95% CI: 0.95-1.39). CONCLUSIONS: In patients with advanced NSCLC harbouring exon 19 deletions, TKIs are associated with better OS compared with conventional chemotherapy. Future clinical trials should take exon 19 deletions and L858R as distinct disease entities and evaluate the treatment efficacy separately.

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  • In a meta-analysis, only afatinib was associated with a statistically significant OS benefit versus chemotherapy among patients with Del19-positive NSCLC treated with erlotinib, gefitinib, or afatinib.

    “in a meta-analysis comparing patients with Del19-positive NSCLC who were treated with erlotinib, gefitinib, or afatinib, only afatinib was associated with a statistically significant OS benefit versus chemotherapy.”

    From Afatinib for the treatment of <i>EGFR</i> mutation-positive NSCLC: A review of clinical findings (2020) · cites this paper as [67]

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Cited by

Sorted by citations

Authors
Kuan, F.-C., Kuo, L.-T., Chen, M.-C., Yang, C.-T., Shi, C.-S., Teng, D., & Lee, K.-D.
Affiliations
  • Chang Gung University (TW)
  • Chang Gung University of Science and Technology (TW)
  • University of California, Los Angeles (US)
Corresponding author
Lee, Kuan-Der
ORCID
Venue
British Journal of Cancer
Publisher
Springer Science and Business Media LLC
Published
2015-10-13
Volume
113
Issue
10
Pages
1519-1528
ISSN
  • 0007-0920 (ISSN-L)
  • 1532-1827
DOI
10.1038/bjc.2015.356
PMC
PMC4815883
OpenAlex
W2180488232
Cited by
101
References
6
Citations by year
2026: 1 · 2025: 6 · 2024: 1 · 2023: 8 · 2022: 14 · 2021: 9 · 2020: 11 · 2019: 12 · 2018: 11 · 2017: 17 · 2016: 11
FWCI
2.31
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Cancer (publishedVersion, cc-by-nc-sa)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
Keywords
EGFR tyrosine kinase inhibitors, EGFR-mutant non-small cell lung cancer, exon 19 deletion, L858R mutation, first-line therapy, overall survival, progression-free survival, chemotherapy comparison
MeSH terms
Antineoplastic Agents, Carcinoma, Non-Small-Cell Lung, Humans, Lung Neoplasms, Mutation, Survival Analysis, Randomized Controlled Trials as Topic, Treatment Outcome, Sequence Deletion, Protein Kinase Inhibitors, ErbB Receptors

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