PMID- 35978809
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220819
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 12
DP  - 2022
TI  - An updated network meta-analysis of EGFR-TKIs and combination therapy in the 
      first-line treatment of advanced EGFR mutation positive non-small cell lung 
      cancer.
PG  - 616546
LID - 10.3389/fonc.2022.616546 [doi]
LID - 616546
AB  - OBJECTIVES: Tyrosine kinase inhibitors (TKIs) are a standard care option in 
      patients with non-small cell lung cancer (NSCLC) with epidermal growth factor 
      receptor (EGFR) mutation. TKI-based combination treatment modes show encouraging 
      outcomes. However, it remains unknown which is the optimal treatment as the 
      first-line regimen for these patients on overall survival (OS). MATERIALS AND 
      METHODS: Randomized controlled trials and meeting abstracts that investigated 
      EGFR-TKIs alone or in combination as front-line care for patients with NSCLC were 
      systematically searched in relevant databases and reviewed. Fixed and random 
      effects network meta-analysis models were used to estimate progression-free 
      survival (PFS), OS, overall response rate, and grade three and higher adverse 
      events (AEs). Surface under the cumulative ranking curves (SUCRAs) were used to 
      rank treatment effects. RESULTS: Eighteen studies covering six treatments and 
      involving a total of 4389 patients were included in this network meta-analysis. 
      On OS, the top three treatment were first-generation EGFR-TKIs (1G EGFR-TKIs) 
      plus chemotherapy (SUCRA, 88.1%), osimertinib (SUCRA, 65.8%) and 
      second-generation EGFR-TKIs (2GEGFR-TKIs) (SUCRA, 63.3%). On PFS, the top three 
      treatments were osimertinib (SUCRA, 96.0%), 1G EGFR-TKIs plus chemotherapy 
      (SUCRA, 67.1%), and 1G EGFR-TKIs plus antiangiogenesis (SUCRA, 48.2%). Two types 
      of TKI-based combination therapy have significantly higher risk of grade three 
      and higher AEs than TKI alone. CONCLUSION: 1G EGFR-TKIs plus chemotherapy and 
      osimertinib seem to be the two better options as first-line care in advanced 
      NSCLC patients with EGFR-mutation. Osimertinib caused the lowest incidence of 
      AEs. However, TKIs-based combination therapy significantly increased AEs.
CI  - Copyright (c) 2022 Qi, Xia, Shao, Guo, Dong, Tian, Xu, Niu and Wei.
FAU - Qi, Yuexiao
AU  - Qi Y
AD  - Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou, 
      China.
FAU - Xia, Xiaojun
AU  - Xia X
AD  - Department of Integrated Traditional Chinese Medicine and Western Medicine, Gansu 
      Provincial Cancer Hospital, Lanzhou, China.
FAU - Shao, Lihua
AU  - Shao L
AD  - Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou, 
      China.
FAU - Guo, Liyun
AU  - Guo L
AD  - Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou, 
      China.
FAU - Dong, Yumei
AU  - Dong Y
AD  - Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou, 
      China.
FAU - Tian, Jinhui
AU  - Tian J
AD  - Center of Evidence Based Medicine, Lanzhou University, Lanzhou, China.
FAU - Xu, Lijun
AU  - Xu L
AD  - Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou, 
      China.
FAU - Niu, Ruijun
AU  - Niu R
AD  - Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou, 
      China.
FAU - Wei, Shihong
AU  - Wei S
AD  - Department of Radiation Oncology, Gansu Provincial Cancer Hospital, Lanzhou, 
      China.
LA  - eng
PT  - Systematic Review
DEP - 20220801
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC9376288
OTO - NOTNLM
OT  - EGFR-TKIs
OT  - anti-angiogenesis
OT  - epidermal growth factor receptor tyrosine kinase inhibitors
OT  - first line
OT  - network meta-analysis
OT  - non-small-cell Lung cancer
OT  - overall survival
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/08/19 06:00
MHDA- 2022/08/19 06:01
PMCR- 2022/01/01
CRDT- 2022/08/18 02:07
PHST- 2020/10/12 00:00 [received]
PHST- 2022/06/27 00:00 [accepted]
PHST- 2022/08/18 02:07 [entrez]
PHST- 2022/08/19 06:00 [pubmed]
PHST- 2022/08/19 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2022.616546 [doi]
PST - epublish
SO  - Front Oncol. 2022 Aug 1;12:616546. doi: 10.3389/fonc.2022.616546. eCollection 
      2022.