Abstract | OBJECTIVES: MATERIALS AND METHODS: Studies were identified via electronic search. The pooled odds ratio (OR) for disease-free survival (DFS) and overall survival (OS) were calculated for the meta-analysis. RESULTS: There were 11 trials (1,152 resected NSCLC patients with EGFR sensitive mutations) in this meta-analysis. The results showed that adjuvant treatment with EGFR-TKIs can prolong both the OS and DFS when compared to treatment without TKIs as an adjuvant therapy (OS: OR, 0.63; 95% CI, 0.46 to 0.87, P = 0.004; heterogeneity I2 = 61%, P = 0.008; DFS: OR, 0.56; 95% CI, 0.43 to 0.72, P < 0.00001; heterogeneity I2 = 37%, P = 0.10). The results of the predefined subgroup analyses in this meta-analysis suggested a greater DFS with the mono EGFR-TKIs compared with chemotherapy, whereas the OS benefit failed to show a similar difference between the two arms (p = 0.30). We also found that treatment with EGFR-TKIs plus chemotherapy was associated with a significantly longer DFS and OS compared to mono chemotherapy in patients with completely resected EGFR-mutant NSCLC (DFS: OR, 0.48; 95% CI, 0.34-0.68; P < 0.0001; heterogeneity I2 = 47%, P = 0.07; OS: OR, 0.50; 95% CI, 0.31-0.78; P = 0.003; heterogeneity I2 = 57%, P = 0.05). Additionally, less severe adverse events (SAEs) were observed in the TKIs group (OR, 0.22; 95% CI, 0.14 to 0.37, P < 0.00001; heterogeneity I2 = 22%, P = 0.28). CONCLUSION: The addition of EGFR-TKIs to adjuvant chemotherapy can prolong the OS and PFS for resected NSCLC. Adjuvant EGFR-TKIs may be a potential treatment option compared to adjuvant chemotherapy in completely resected patients with EGFR mutation-positive NSCLC. STATEMENT OF SIGNIFICANCE:
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Authors | Wenjie Tang, Xiaolin Li, Xueqi Xie, Xindong Sun, Jie Liu, Jian Zhang, Chungang Wang, Jinming Yu, Peng Xie |
Journal | Lung cancer (Amsterdam, Netherlands)
(Lung Cancer)
Vol. 136
Pg. 6-14
(10 2019)
ISSN: 1872-8332 [Electronic] Ireland |
PMID | 31421260
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 Elsevier B.V. All rights reserved. |
Chemical References |
- Protein Kinase Inhibitors
- EGFR protein, human
- ErbB Receptors
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Topics |
- Carcinoma, Non-Small-Cell Lung
(drug therapy, genetics, mortality, pathology)
- Chemotherapy, Adjuvant
- Clinical Trials as Topic
- ErbB Receptors
(antagonists & inhibitors, genetics)
- Humans
- Lung Neoplasms
(drug therapy, genetics, mortality, pathology)
- Mutation
- Neoplasm Staging
- Odds Ratio
- Prognosis
- Protein Kinase Inhibitors
(administration & dosage, adverse effects, therapeutic use)
- Publication Bias
- Treatment Outcome
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