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Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs
BACKGROUND: Despite the well‐established efficacies of tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor (EGFR)‐mutated non‐small cell lung cancer (NSCLC), there is limited real‐world evidence comparing their effectiveness according to patients’ clinical characteristics. This net...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons Australia, Ltd
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643796/ https://www.ncbi.nlm.nih.gov/pubmed/37737541 http://dx.doi.org/10.1111/1759-7714.15111 |
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author | Chang, Huang‐Chih Wang, Chin‐Chou Tseng, Chia‐Cheng Huang, Kuo‐Tung Chen, Yu‐Mu Chang, Yu‐Ping Lai, Chien‐Hao Fang, Wen‐Feng Lin, Meng‐Chih Chuang, Hung‐Yi |
author_facet | Chang, Huang‐Chih Wang, Chin‐Chou Tseng, Chia‐Cheng Huang, Kuo‐Tung Chen, Yu‐Mu Chang, Yu‐Ping Lai, Chien‐Hao Fang, Wen‐Feng Lin, Meng‐Chih Chuang, Hung‐Yi |
author_sort | Chang, Huang‐Chih |
collection | PubMed |
description | BACKGROUND: Despite the well‐established efficacies of tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor (EGFR)‐mutated non‐small cell lung cancer (NSCLC), there is limited real‐world evidence comparing their effectiveness according to patients’ clinical characteristics. This network meta‐analysis (NMA) compared survival outcomes among first‐line EGFR‐TKIs in different subgroups of East Asian patients with advanced NSCLC. METHODS: This NMA included real‐world observational studies reporting outcomes with TKIs in patients aged >65 years, with baseline brain metastasis, with different Eastern Cooperative Oncology Group (ECOG) statuses, or with different common EGFR mutation types. RESULTS: In patients with the EGFR L858R mutation, afatinib resulted in significantly longer progression‐free survival (PFS) than erlotinib (hazard ratio [HR]: 0.59, 95% confidence interval [CI]: 0.46–0.75) and gefitinib (HR: 0.41, 95% CI: 0.32–0.53). Similarly, in patients with the EGFR Del19 mutation, afatinib and erlotinib resulted in significantly longer PFS than gefitinib (HR: 0.48 with 95% CI: 0.33–0.71 and HR: 0.54 with 95% CI: 0.36–0.80, respectively). Moreover, afatinib resulted in significantly longer PFS than gefitinib in patients with brain metastasis (HR: 0.53, 95% CI: 0.33–0.87) or ECOG status 0–1 (HR: 0.37, 95% CI: 0.23–0.59). CONCLUSION: This NMA suggests that afatinib results in similar PFS to erlotinib and superior PFS than gefitinib in patients with Del19 mutant NSCLC, aged ≥65 years, with ECOG scores of 0–1, and with baseline brain metastasis. |
format | Online Article Text |
id | pubmed-10643796 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley & Sons Australia, Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-106437962023-11-15 Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs Chang, Huang‐Chih Wang, Chin‐Chou Tseng, Chia‐Cheng Huang, Kuo‐Tung Chen, Yu‐Mu Chang, Yu‐Ping Lai, Chien‐Hao Fang, Wen‐Feng Lin, Meng‐Chih Chuang, Hung‐Yi Thorac Cancer Original Articles BACKGROUND: Despite the well‐established efficacies of tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor (EGFR)‐mutated non‐small cell lung cancer (NSCLC), there is limited real‐world evidence comparing their effectiveness according to patients’ clinical characteristics. This network meta‐analysis (NMA) compared survival outcomes among first‐line EGFR‐TKIs in different subgroups of East Asian patients with advanced NSCLC. METHODS: This NMA included real‐world observational studies reporting outcomes with TKIs in patients aged >65 years, with baseline brain metastasis, with different Eastern Cooperative Oncology Group (ECOG) statuses, or with different common EGFR mutation types. RESULTS: In patients with the EGFR L858R mutation, afatinib resulted in significantly longer progression‐free survival (PFS) than erlotinib (hazard ratio [HR]: 0.59, 95% confidence interval [CI]: 0.46–0.75) and gefitinib (HR: 0.41, 95% CI: 0.32–0.53). Similarly, in patients with the EGFR Del19 mutation, afatinib and erlotinib resulted in significantly longer PFS than gefitinib (HR: 0.48 with 95% CI: 0.33–0.71 and HR: 0.54 with 95% CI: 0.36–0.80, respectively). Moreover, afatinib resulted in significantly longer PFS than gefitinib in patients with brain metastasis (HR: 0.53, 95% CI: 0.33–0.87) or ECOG status 0–1 (HR: 0.37, 95% CI: 0.23–0.59). CONCLUSION: This NMA suggests that afatinib results in similar PFS to erlotinib and superior PFS than gefitinib in patients with Del19 mutant NSCLC, aged ≥65 years, with ECOG scores of 0–1, and with baseline brain metastasis. John Wiley & Sons Australia, Ltd 2023-09-22 /pmc/articles/PMC10643796/ /pubmed/37737541 http://dx.doi.org/10.1111/1759-7714.15111 Text en © 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Chang, Huang‐Chih Wang, Chin‐Chou Tseng, Chia‐Cheng Huang, Kuo‐Tung Chen, Yu‐Mu Chang, Yu‐Ping Lai, Chien‐Hao Fang, Wen‐Feng Lin, Meng‐Chih Chuang, Hung‐Yi Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs |
title | Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs
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title_full | Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs
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title_fullStr | Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs
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title_full_unstemmed | Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs
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title_short | Do patient characteristics affect EGFR tyrosine kinase inhibitor treatment outcomes? A network meta‐analysis of real‐world survival outcomes of East Asian patients with advanced non‐small cell lung cancer treated with first‐line EGFR‐TKIs
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title_sort | do patient characteristics affect egfr tyrosine kinase inhibitor treatment outcomes? a network meta‐analysis of real‐world survival outcomes of east asian patients with advanced non‐small cell lung cancer treated with first‐line egfr‐tkis |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643796/ https://www.ncbi.nlm.nih.gov/pubmed/37737541 http://dx.doi.org/10.1111/1759-7714.15111 |
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