Patients with Exon 19 Deletion Were Associated with Longer Progression-Free Survival Compared to Those with L858R Mutation after First-Line EGFR-TKIs for Advanced Non-Small Cell Lung Cancer: A Meta-AnalysisReportar como inadecuado




Patients with Exon 19 Deletion Were Associated with Longer Progression-Free Survival Compared to Those with L858R Mutation after First-Line EGFR-TKIs for Advanced Non-Small Cell Lung Cancer: A Meta-Analysis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Backgrounds

It has been extensively proved that the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors EGFR-TKIs is superior to that of cytotoxic chemotherapy in advanced non-small cell lung cancer NSCLC patients harboring sensitive EGFR mutations. However, the question of whether the efficacy of EGFR-TKIs differs between exon 19 deletion and exon 21 L858R mutation has not been yet statistically answered.

Methods

Subgroup data on hazard ratio HR for progression-free survival PFS of correlative studies were extracted and synthesized based on random-effect model. Comparison of outcomes between specific mutations was estimated through indirect and direct methods, respectively.

Results

A total of 13 studies of advanced NSCLC patients with either 19 or 21 exon alteration receiving first-line EGFR-TKIs were included. Based on the data from six clinical trials for indirect meta-analysis, the pooled HRTKI-chemotherapy for PFS were 0.28 95% CI 0.20–0.38, P<0.001 in patients with 19 exon deletion and 0.47 95% CI 0.35–0.64, P<0.001 in those with exon 21 L858R mutation. Indirect comparison revealed that the patients with exon 19 deletion had longer PFS than those with exon 21 L858R mutation HR19 exon deletion-exon 21 L858R mutation  = 0.59, 95% CI 0.38–0.92; P = 0.019. Additionally, direct meta-analysis showed similar result HR19 exon deletion-exon 21 L858R mutation  = 0.75, 95% CI 0.65 to 0.85; P<0.001 by incorporating another seven studies.

Conclusions

For advanced NSCLC patients, exon 19 deletion might be associated with longer PFS compared to L858 mutation at exon 21 after first-line EGFR-TKIs.



Autor: Yaxiong Zhang , Jin Sheng , Shiyang Kang , Wenfeng Fang, Yue Yan, Zhihuang Hu, Shaodong Hong, Xuan Wu, Tao Qin, Wenhua Liang , Li

Fuente: http://plos.srce.hr/



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