NSCLC: adjuvant TKI therapy more beneficial in stage IIIa disease

  • Lu D & al.
  • Cancer Manag Res
  • 1 janv. 2019

  • Par Kelli Whitlock Burton
  • Résumés d'articles
L'accès à l'intégralité du contenu de ce site est reservé uniquement aux professionnels de santé disposant d'un compte. L'accès à l'intégralité du contenu de ce site est reservé uniquement aux professionnels de santé disposant d'un compte.

Takeaway

  • Postoperative treatment with adjuvant epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) offered improved OS and DFS in patients with NSCLC, but primarily in those with stage IIIA disease and those positive for EGFR mutations.

Why this matters

  • Trials on the efficacy of EGFR-TKIs in different patient groups have yielded conflicting results.

Study design

  • Meta-analysis of 9 studies with 2467 patients with stage I-IIIA NSCLC who received adjuvant TKIs (n=1248) and those who received chemotherapy or placebo (control group; n=1209).
  • Funding: Nanfang Hospital, Southern Medical University, China.

Key results

  • Adjuvant EGFR-TKIs yielded better DFS than controls (HR, 0.77; 95% CI, 0.68-0.88), but not OS (HR, 1.01; 95% CI, 0.85-1.19).
  • In EGFR-positive patients, EGFR-TKIs offered significantly better DFS (HR, 0.49; 95% CI, 0.40-0.61) and OS (HR, 0.48; 95% CI, 0.32-0.71) than controls.
  • No significant difference in DFS or OS with EGFR-TKIs in studies with >50% stage I patients.
  • EGFR-TKIs were associated with significantly better DFS and OS in studies with >30% stage IIIa patients (DFS HR, 0.46 [95% CI, 0.35-0.60]; OS HR, 0.42 [95% CI, 0.24-0.73]).

Limitations

  • Analysis included some retrospective studies and included no patient-level data.