15 December 2014 : Special report
Efficacy of EGFR Tyrosine Kinase Inhibitors in Non-Small-Cell Lung Cancer Patients with/without EGFR-Mutation: Evidence Based on Recent Phase III Randomized TrialsWen-Qian ZhangABCDEF, Tong LiBCDEF, Hui LiABCDEFG
Med Sci Monit 2014; 20:2666-2676
ABSTRACT: Background: EGFR mutation might be a predictive factor for applying EGFR-tyrosine kinase inhibitors (EGFR-TKIs, including gefitinib, erlotinib and afatinib) in non-small-cell lung cancer (NSCLS) patients. Thus, it is necessary to pool previous trials to compare the effect of EGFR-TKIs versus cytotoxic chemotherapy in EGFR mutation positive (mut+) and negative (mut–) patients. Material and Methods: This study identified 8 first-line and 9 second-line phase III trials in databases. Hazard ratio (HR) was pooled to assess the risk of progression-free survival (PFS), and overall survival (OS), while odds ratio (OR) was pooled to assess objective response, disease control, and toxicity of EGFR-TKIs verses chemotherapy. Results: In EGFR mut+ patients, EGFR-TKIs were associated with significantly lower risk of disease progression in the first-line setting, but this trend was only observed in the gefitinib group, not in the erlotinib group in the second-line setting. In EGFR mut– patients, gefitinib and erlotinib had significantly higher risk of disease progression in first-line and second-line setting, respectively. Compared with chemotherapy, the effects of EGFR-TKIs on OS in both first-line and second-line settings were not evident. Regarding toxicity, EGFR-TKIs had significantly higher risk of rash and lower hematological toxicity compared with chemotherapy. Conclusions: All of the 3 EGFR-TKIs and gefitinib alone regimens had better effects in prolonging PFS in EGFR mut+ patients in first-line and second-line setting, respectively, but chemotherapy seemed more effective in EGFR mut- patients than EGFR-TKIs. Therefore, accurate identification of EGFR mutation status is useful to decide on an appropriate regimen for treatment of NSCLC patients.
Keywords: Carcinoma, Non-Small-Cell Lung - genetics, Clinical Trials, Phase III as Topic, Disease-Free Survival, Lung Neoplasms - genetics, Mutation - genetics, Protein Kinase Inhibitors - therapeutic use, Randomized Controlled Trials as Topic, Receptor, Epidermal Growth Factor - genetics
01 January 2022 : EditorialEditorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Patients
Med Sci Monit 2022; 28:e935952
11 January 2022 : Clinical ResearchA Remote Questionnaire-Based Study to Compare Alcohol Use in 1030 Final-Year High School Students in Split-...
Med Sci Monit In Press; DOI: 10.12659/MSM.935567
08 November 2021 : Database AnalysisVirtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...
Med Sci Monit In Press; DOI: 10.12659/MSM.934102
31 December 2021 : Clinical ResearchA Prospective Observational Study of 42 Patients with COVID-19 infection and a History of Hepatitis C Virus...
Med Sci Monit 2021; 27:e935075
17 Jan 2022 : Clinical ResearchUnveiling the Differences in Biological Properties of Dental Pulp Stem Cells from Normal and Inflamed Pulp:...
Med Sci Monit In Press; DOI: 10.12659/MSM.934511
14 Jan 2022 : Database AnalysisIdentification of Key Genes Associated with Brain Metastasis from Breast Cancer: A Bioinformatics Analysis
Med Sci Monit In Press; DOI: 10.12659/MSM.935071
13 Jan 2022 : Review articleA Review of Current Clinical Concepts in the Pathophysiology, Etiology, Diagnosis, and Management of Hyperc...
Med Sci Monit In Press; DOI: 10.12659/MSM.935821
Most Viewed Current Articles
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
01 Nov 2020 : Review articleLong-Term Respiratory and Neurological Sequelae of COVID-19
Med Sci Monit 2020; 26:e928996
05 Mar 2020 : Clinical ResearchThe Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease ...
Med Sci Monit 2020; 26:e923549