EGFR-Tyrosine Kinase Inhibitor Retreatment in Non-Small-Cell Lung Cancer Patients Previously Exposed to EGFR-TKI: A Systematic Review and Meta-Analysis

We performed a systematic review and meta-analysis to assess the efficacy of EGFR-tyrosine kinase inhibitors (TKI) retreatment in advanced/metastatic non-small-cell lung cancer (NSCLC) patients. We systematically searched PubMed, Embase, Cochrane databases, ASCO, and ESMO websites for studies evalua...

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Bibliographic Details
Published in:Journal of personalized medicine 2024-07, Vol.14 (7), p.752
Main Authors: Michelon, Isabella, Vilbert, Maysa, do Rego Castro, Caio Ernesto, Stecca, Carlos, Dacoregio, Maria Inez, Rizzo, Manglio, Cláudio Cordeiro de Lima, Vladmir, Cavalcante, Ludimila
Format: Article
Language:English
Subjects:
Bias
Cancer therapies
Cell cycle
Chemotherapy
Clinical trials
Cohort analysis
Epidermal growth factor
Epidermal growth factor receptors
Kinases
Lung cancer
Meta-analysis
Metastases
Metastasis
Mutation
Non-small cell lung carcinoma
Patients
Small cell lung carcinoma
Software
Systematic review
Tyrosine kinase inhibitors
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Summary:We performed a systematic review and meta-analysis to assess the efficacy of EGFR-tyrosine kinase inhibitors (TKI) retreatment in advanced/metastatic non-small-cell lung cancer (NSCLC) patients. We systematically searched PubMed, Embase, Cochrane databases, ASCO, and ESMO websites for studies evaluating EGFR-TKI retreatment in advanced/metastatic NSCLC patients. All analyses were performed using R software (v.4.2.2). We included 19 studies (9 CTs and 10 retrospective cohorts) with a total of 886 patients. In a pooled analysis of all patients during retreatment with TKI, median OS was 11.7 months (95% confidence interval [CI] 10.2-13.4 months) and PFS was 3.2 months (95% CI 2.5-3.9 months). ORR was 15% (95% CI 10-21%) and DCR was 61% (95% CI 53-67%). The subanalysis by generation of TKI in the rechallenge period revealed a slightly better ORR for patients on 3rd generation TKI ( = 0.05). Some limitations include the high heterogeneity of some of the analyses and inability to perform certain subanalyses. Our results unequivocally support the benefit of EGFR-TKI rechallenge in EGFR-mutated NSCLC patients progressing on TKI treatment after a TKI-free interval. These findings may be especially valuable in areas where access to novel therapeutic drugs and clinical trials is limited.
ISSN:2075-4426
2075-4426
DOI:10.3390/jpm14070752