Predictors of outcome for patients with lung adenocarcinoma carrying the epidermal growth factor receptor mutation receiving 1st-line tyrosine kinase inhibitors: Sensitivity and meta-regression analysis of randomized trials

Abstract Purpose We performed a sensitivity and meta-regression analysis, cumulating all randomized trials exploring the benefit of afatinib, erlotinib and gefitinib versus chemotherapy in advanced EGFR mutant NSCLC, to investigate the potential role of additional clinico-pathological predictors of...

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Published in:Critical reviews in oncology/hematology 2014-05, Vol.90 (2), p.135-145
Main Authors: Pilotto, Sara, Di Maio, Massimo, Peretti, Umberto, Kinspergher, Stefania, Brunelli, Matteo, Massari, Francesco, Sperduti, Isabella, Giannarelli, Diana, De Marinis, Filippo, Tortora, Giampaolo, Bria, Emilio
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Afatinib
Erlotinib
Ethnicity
Gefitinib
Hematology, Oncology and Palliative Medicine
Humans
Lung cancer
Lung Neoplasms - drug therapy
Meta-analysis
Mutation
Protein Kinase Inhibitors - therapeutic use
Protein-Tyrosine Kinases - antagonists & inhibitors
Randomized Controlled Trials as Topic
Receptor, Epidermal Growth Factor - genetics
Regression Analysis
Trial design
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Summary:Abstract Purpose We performed a sensitivity and meta-regression analysis, cumulating all randomized trials exploring the benefit of afatinib, erlotinib and gefitinib versus chemotherapy in advanced EGFR mutant NSCLC, to investigate the potential role of additional clinico-pathological predictors of TKIs efficacy. Results With regard to progression-free survival (PFS), a significant interaction according to ethnicity (Asian versus Caucasian versus mixed) and to trial design (retrospective versus prospective EGFR analysis), was found; a trend toward significance with regard to type of drug (gefitinib versus erlotinib versus afatinib) was determined. No statistically significant differences in survival were observed. With regard to response, a significant interaction according to ethnicity, trial design and type of drug, was found. Conclusion These data, together with a deeper characterization of the molecular background sustaining the oncogenic process, may contribute to create a clinico-pathologic predictive model, aimed to improve the magnitude of benefit expected from the use of targeted agents.
ISSN:1040-8428
1879-0461
DOI:10.1016/j.critrevonc.2013.11.005