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Ethnic differences in survival outcome in patients with advanced stage non-small cell lung cancer: results of a meta-analysis of randomized controlled trials

Authors
 Ross A. Soo  ;  Marie Loh  ;  Tony S. Mok  ;  Sai-Hong I. Ou  ;  Byoung-Chul Cho  ;  Wee-Lee Yeo  ;  Dan G. Tenen  ;  Richie Soong 
Citation
 JOURNAL OF THORACIC ONCOLOGY, Vol.6(6) : 1030-1038, 2011 
Journal Title
JOURNAL OF THORACIC ONCOLOGY
ISSN
 1556-0864 
Issue Date
2011
MeSH
Adult ; Aged ; Antineoplastic Agents/therapeutic use ; Asian Continental Ancestry Group/statistics & numerical data* ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/ethnology* ; Carcinoma, Non-Small-Cell Lung/mortality* ; Carcinoma, Non-Small-Cell Lung/pathology ; Disease Progression ; Disease-Free Survival ; European Continental Ancestry Group/statistics & numerical data* ; Female ; Health Status Disparities ; Humans ; Lung Neoplasms/drug therapy ; Lung Neoplasms/ethnology* ; Lung Neoplasms/mortality* ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Randomized Controlled Trials as Topic ; Survival Analysis ; Time Factors ; Treatment Outcome
Keywords
Non-small cell lung cancer ; Meta-analysis ; Asian ; Caucasian ; Ethnicity ; Chemotherapy
Abstract
INTRODUCTION: Although interethnic differences in survival to cytotoxic chemotherapy in patients with non-small cell lung cancer exist, an analysis of survival outcomes based on ethnicity has not yet been fully evaluated systematically using large patient cohorts. Furthermore, recent trial results may be confounded by the use of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI).

METHODS: A meta-analysis was performed using trials identified through MEDLINE. Summary data on median overall survival (OS), time to progression, progression-free survival, and overall response rate (ORR) were collected from randomized controlled trials. Outcomes were compared between Asian and Caucasian studies.

RESULTS: Of the 1182 citations identified, 391 treatment arms (Asian 90 and Caucasian 301) were analyzed. The median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 10.1 and 8.0 months (p < 0.001) and 32.2 and 25.9% (p < 0.001), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination was 9.9 and 6.8 months, 10.4 and 8.6 months, and 9.4 and 8.0 months, respectively (all p < 0.001). In studies published pre-EGFR TKI, the median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 9.1 versus 7.3 months (p < 0.001), respectively, and 29.0 and 23.0% (p < 0.006), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination pre-EGFR TKI was 8.9 and 6.5 months (p < 0.005), 9.1 and 7.5 months (p < 0.001), and 9.3 and 7.6 months (p < 0.003), respectively. In third-generation platinum doublets, the median OS in Asian and Caucasian studies was 11.3 and 9.5 months (p < 0.001), respectively, and ORR was 35.0 and 29.8% (p < 0.001), respectively.

CONCLUSION: Ethnic differences in survival and response rate to chemotherapy exist and should be considered in clinical trial designs especially in the global context.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=01243894-201106000-00009&LSLINK=80&D=ovft
DOI
10.1097/JTO.0b013e3182199c03.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94214
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