EGFR-TKI Improves Disease-Free Survival in Resectable NSCLC
Adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment for patients with EGFR-mutant non-small cell lung cancer (NSCLC) after complete resection offers a significant disease-free survival advantage, according to result of a meta-analysis published in the Journal of Thoracic Disease (December 2017;9).
Prior research suggested a survival benefit from EGFR-TKIs after surgery in patients with EGFR-mutant NSCLC. However, long-term survival data is needed to determine efficacy of this treatment strategy.
A group of Chinese researchers conducted a meta-analysis of their previous study to provide the latest updates through the past 3 years. The follow-up study included a comprehensive range of relevant studies in PubMed.
Disease-free survival with hazard ratios (HRs) were determined using random and fixed-effects models. Subgroup analysis and meta-regression analysis were also performed.
Researchers noted that a total of 2489 patients across seven studies were eligible for the follow-up meta-analysis.
Results of the study showed that adjuvant EGFR-TKI administration was significantly associated with superior disease-free survival (HR, 0.60; 95% CI, 0.42-0.87), which corresponded to an absolute benefit of 3.4% at 3 years, still with substantial heterogeneity (P < .001).
Additionally, researchers reported that EGFR mutation rate among the included patients was found to be a source of heterogeneity by meta-regression analysis (P = .005). In a sub-population of EGFR-mutant patients, the HR for disease-free survival was 0.51 (95% CI, 0.39-0.65), which corresponded to an absolute benefit of 7.1% at 3 years.
The rate of overall grade 3 or higher adverse events was 38.9% (95% CI, 35.9% - 41.9%).
In their concluding remarks, researchers asserted that the updated meta-analysis provided “strengthened evidence of significant disease-free survival advantage of adjuvant EGFR-TKI treatment for patients with EGFR-mutant NSCLC after complete resection.”—Zachary Bessette