Efficacy and safety of tyrosine kinase inhibitors in advanced non-small-cell lung cancer harboring epidermal growth factor receptor mutation: a network meta-analysis

To compare the efficacy and safety of tyrosine kinase inhibitors (TKIs) as first-line treatment in patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) with positive mutation. Following a systematic literature review until December 2019, we conducted a random-effects pairw...

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Bibliographic Details
Published in:Lung cancer management 2020-11, Vol.10 (1)
Main Authors: Alanazi, Abdullah, Yunusa, Ismaeel, Elenizi, Khaled, Alzarea, Abdulaziz I
Format: Article
Language:English
Subjects:
Bias
Cancer therapies
Chemotherapy
Clinical trials
Cytotoxicity
Drugs
Epidermal growth factor
epidermal growth factor receptor
Kinases
Lung cancer
Meta-Analysis
Mutation
network meta-analysis
Patients
Population
Software
Targeted cancer therapy
tyrosine kinase inhibitors
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Summary:To compare the efficacy and safety of tyrosine kinase inhibitors (TKIs) as first-line treatment in patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) with positive mutation. Following a systematic literature review until December 2019, we conducted a random-effects pairwise and network meta-analyses (NMA). We ranked treatments for efficacy and safety based on the surface under the cumulative ranking curve (SUCRA). Tyrosine kinase inhibitors of the epidermal growth factor receptor (EGFR-TKI) improved survival outcomes with fewer grade 3 or higher adverse events compared to chemotherapy. Overall survival results suggest that osimertinib has the highest probability of being the most efficacious (SUCRA, 79.9%), followed by dacomitinib (SUCRA, 75.8%). Adverse events results suggest that osimertinib (SUCRA, 84.3%) and gefitinib (SUCRA, 78.9%) has the highest probability of being the safest. In this NMA, we found that osimertinib is the most efficacious and safest EGFR-TKI. These results may guide clinicians in choosing the most appropriate treatment option among EGFR-TKIs for their patient’s individual clinical characteristics.
ISSN:1758-1966
1758-1974
DOI:10.2217/lmt-2020-0011