The impact of both platinum-based chemotherapy and EGFR-TKIs on overall survival of patients with advanced non-small cell lung cancer.
- Author:
Jian-Wei ZHANG
1
,
2
;
Yuan-Yuan ZHAO
;
Ying GUO
;
Cong XUE
;
Zhi-Huang HU
;
Yan HUANG
;
Hong-Yun ZHAO
;
Jing ZHANG
;
Xuan WU
;
Wen-Feng FANG
;
Yu-Xiang MA
;
Li ZHANG
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Carcinoma, Non-Small-Cell Lung; drug therapy; genetics; pathology; Clinical Trials, Phase III as Topic; Disease-Free Survival; Female; Humans; Lung Neoplasms; drug therapy; genetics; pathology; Male; Middle Aged; Neoplasm Staging; Platinum; administration & dosage; Protein Kinase Inhibitors; therapeutic use; Randomized Controlled Trials as Topic; Receptor, Epidermal Growth Factor; antagonists & inhibitors; genetics; Survival Rate
- From:Chinese Journal of Cancer 2014;33(2):105-114
- CountryChina
- Language:English
- Abstract: Both platinum-based doublet chemotherapy (PBC) and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) prolong the survival of patients with advanced non-small cell lung cancer (NSCLC). In early studies, most patients underwent PBC as first-line treatment, but not all patients could afford EGFR-TKIs as second-line treatment. To understand the impact of PBC and EGFR-TKIs on NSCLC prognosis, we evaluated the association between the receipt of both regimens and overall survival (OS). Using MEDLINE and EMBASE, we identified prospective, randomized, controlled phase III clinical trials in advanced NSCLC that met the inclusion criteria: in general population with advanced NSCLC, the percentage of patients treated with both PBC and EGFR-TKIs was available in the trial and OS was reported. After collecting data from the selected trials, we correlated the percentage of patients treated with both PBC and EGFR-TKIs with the reported OS, using a weighted analysis. Fifteen phase III clinical trials--involving 11,456 adult patients in 32 arms--were included in the analysis, including 6 trials in Asian populations and 9 in non-Asian (predominantly Caucasian) populations. The OS was positively correlated with the percentage of patients treated with both PBC and EGFR-TKIs (r = 0.797, P < 0.001). The correlation was obvious in the trials in Asian populations (r = 0.936, P < 0.001) but was not statistically significant in the trials in predominantly Caucasian populations (r = 0.116, P = 0.588). These results suggest that treatment with PBC and EGFR-TKIs may provide a survival benefit to patients with advanced NSCLC, highlighting the importance of having both modalities available for therapy.
