Network meta analysis of first-line therapy for advanced EGFR mutation positive non-small-cell lung cancer: updated overall survival

Future Oncol. 2020 Dec;16(36):3107-3116. doi: 10.2217/fon-2020-0541. Epub 2020 Sep 1.

Abstract

Aim: To update overall survival (OS) results from a previous network meta analysis comparing the relative clinical efficacy of epidermal growth factor receptor-targeted tyrosine kinase inhibitors (EGFR TKIs) for EGFR mutation positive (EGFR+) advanced non-small-cell lung cancer (NSCLC). Materials & methods: A Bayesian network meta analysis was conducted using updated/mature randomized controlled trial OS results in response to first-line EGFR TKI therapies. Results: Dacomitinib showed a numerical improvement of OS relative to other EGFR TKIs: afatinib (hazard ratio [HR]: 0.87; 95% credible interval [CrI]: 0.61-1.24), erlotinib (HR: 0.79; 95% CrI: 0.44-1.42), gefitinib (HR: 0.75; 95% CrI: 0.59-0.95) and osimertinib (HR: 0.94; 95% CrI: 0.68-1.29). Conclusion: Dacomitinib should be considered as a first-line treatment option for patients diagnosed with advanced EGFR+ NSCLC.

Keywords: EGFR; EGFR mutation positive; TKI; network meta analysis; non-small-cell lung cancer; overall survival; tyrosine kinase inhibitors.

Publication types

  • Comparative Study

MeSH terms

  • Acrylamides / pharmacology
  • Acrylamides / therapeutic use
  • Afatinib / pharmacology
  • Afatinib / therapeutic use
  • Aniline Compounds / pharmacology
  • Aniline Compounds / therapeutic use
  • Bayes Theorem
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Disease-Free Survival
  • ErbB Receptors / antagonists & inhibitors
  • ErbB Receptors / genetics
  • Erlotinib Hydrochloride / pharmacology
  • Erlotinib Hydrochloride / therapeutic use
  • Gain of Function Mutation
  • Gefitinib / pharmacology
  • Gefitinib / therapeutic use
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / mortality
  • Neoplasm Staging
  • Network Meta-Analysis
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use*
  • Quinazolinones / pharmacology
  • Quinazolinones / therapeutic use*
  • Randomized Controlled Trials as Topic

Substances

  • Acrylamides
  • Aniline Compounds
  • Protein Kinase Inhibitors
  • Quinazolinones
  • osimertinib
  • Afatinib
  • dacomitinib
  • Erlotinib Hydrochloride
  • EGFR protein, human
  • ErbB Receptors
  • Gefitinib

Grants and funding