PMID- 37584242
OWN - NLM
STAT- Publisher
LR  - 20231010
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 12
IP  - 18
DP  - 2023 Sep
TI  - The efficacy and safety of immune checkpoint inhibitors for patients with 
      EGFR-mutated non-small cell lung cancer who progressed on EGFR tyrosine-kinase 
      inhibitor therapy: A systematic review and network meta-analysis.
PG  - 18516-18530
LID - 10.1002/cam4.6453 [doi]
AB  - BACKGROUND: Non-small cell lung cancer (NSCLC) patients harboring epidermal 
      growth factor receptor (EGFR)-mutated who progressed on EGFR tyrosine-kinase 
      inhibitor (EGFR-TKI) therapy have limited therapeutic options. There is still no 
      consensus on the role of immune checkpoint inhibitors (ICIs) in NSCLC with EGFR 
      mutations. METHODS: We did a network meta-analysis (NMA) with a systematic 
      literature search on PubMed, Embase, Web of Science, and The Cochrane Library. We 
      included all phase II and III randomized controlled trials (RCTs), non-randomized 
      controlled trials (Non-RCTs), and retrospective studies. Progression-free 
      survival (PFS) and overall survival (OS) were assessed through hazard ratios 
      (HR). Objective response rate (ORR) and adverse events (AEs) were assessed 
      through odds ratio (OR) and relative risk (RR), respectively. R software was used 
      to compare the outcomes of different treatments by Bayesian NMA. FINDINGS: We 
      identified 1835 published results and 17 studies were included ultimately. A 
      total of 2085 patients were included and accepted the following six treatments: 
      ICIs plus chemotherapy (ICIs+Chemo), chemotherapy (Chemo), ICIs monotherapy 
      (ICIs), ICIs plus chemotherapy and antiangiogenic therapy (ICIs+Chemo+Antiangio), 
      antiangiogenic therapy plus chemotherapy (Antiangio+Chemo), ICIs plus 
      antiangiogenic therapy (ICIs+Antiangio). ICIs+Chemo+Antiangio was associated with 
      longer PFS and OS, as well as higher ORR (surface under the cumulative ranking 
      curve [SUCRA], 96%, 90%, 91%). ICIs conferred the safety profile in terms of 
      any-grade AEs, grade greater than or equal to 3 AEs and any grade leading to 
      treatment discontinuation occurred AEs (SUCRA, 99%, 68%, 94%). INTERPRETATION: 
      ICIs+Chemo+Antiangio brings the greatest survival benefit in NSCLC patients with 
      EGFR mutations who progressed on EGFR-TKI therapy, even for whom with baseline 
      brain metastases. Compared with chemotherapy, ICIs has a low incidence of AEs and 
      a benefit in OS.
CI  - (c) 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Wang, Zhen
AU  - Wang Z
AD  - Department of Radiotherapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao 
      University, Yantai, China.
FAU - Zhou, Fang
AU  - Zhou F
AD  - Department of Radiotherapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao 
      University, Yantai, China.
FAU - Xu, Shan
AU  - Xu S
AD  - Department of Oncology, Zaozhuang Municipal Hospital, Zao Zhuang, China.
FAU - Wang, Kang
AU  - Wang K
AD  - Department of Oncology, Zaozhuang Municipal Hospital, Zao Zhuang, China.
FAU - Ding, Huan
AU  - Ding H
AUID- ORCID: 0000-0002-3853-6973
AD  - Department of Oncology, Zaozhuang Municipal Hospital, Zao Zhuang, China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230816
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
SB  - IM
PMC - PMC10557893
OTO - NOTNLM
OT  - adverse events
OT  - efficacy
OT  - epidermal growth factor receptor
OT  - immune checkpoint inhibitors
OT  - network meta-analysis
OT  - non-small cell lung cancer
COIS- The authors declare no conflicts of interest.
EDAT- 2023/08/16 06:43
MHDA- 2023/08/16 06:43
PMCR- 2023/08/16
CRDT- 2023/08/16 05:52
PHST- 2023/07/22 00:00 [revised]
PHST- 2023/05/09 00:00 [received]
PHST- 2023/08/04 00:00 [accepted]
PHST- 2023/08/16 06:43 [pubmed]
PHST- 2023/08/16 06:43 [medline]
PHST- 2023/08/16 05:52 [entrez]
PHST- 2023/08/16 00:00 [pmc-release]
AID - CAM46453 [pii]
AID - 10.1002/cam4.6453 [doi]
PST - ppublish
SO  - Cancer Med. 2023 Sep;12(18):18516-18530. doi: 10.1002/cam4.6453. Epub 2023 Aug 
      16.