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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

Authors
 H J Lee  ;  G H Jeong  ;  H Li  ;  M S Kim  ;  J S Kim  ;  S J Park  ;  Y J Han  ;  K H Lee  ;  A Kronbichler  ;  S H Hong  ;  R A Ghayda  ;  C Luchini  ;  A Nottegar  ;  A Koyanagi  ;  L Smith  ;  L Jacob  ;  E Dragioti  ;  J Radua  ;  S Cargnin  ;  S Terrazzino  ;  T Thompson  ;  D K Yon  ;  S W Lee  ;  J M Yang  ;  P Wasuwanich  ;  J I Shin  ;  G Gamerith 
Citation
 EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, Vol.25(20) : 6232-6244, 2021-10 
Journal Title
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES
ISSN
 1128-3602 
Issue Date
2021-10
Abstract
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.
Files in This Item:
T202105240.pdf Download
DOI
10.26355/eurrev_202110_26993
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Lee, Keum Hwa(이금화) ORCID logo https://orcid.org/0000-0002-1511-9587
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187183
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