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BIM deletion polymorphism predicts poor response to EGFR-TKIs in nonsmall cell lung cancer: An updated meta-analysis

Wenxia Su1, Xiaoyun Zhang1, Xin Cai1

  • 1Department of Physiology.

Medicine
|March 12, 2019
PubMed
Abstract

Insights

Non-small cell lung cancer (NSCLC) patients with BIM deletion polymorphism show a poorer response to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). This genetic marker indicates a reduced likelihood of treatment success and can help identify patients who may not benefit from EGFR-TKIs.

Area of Science:

  • Oncology
  • Genetics
  • Pharmacogenomics

Background:

  • Germline deletion in the BIM gene is implicated in reduced apoptotic response to EGFR TKIs in vitro.
  • The clinical significance of BIM deletion polymorphism in NSCLC patients treated with EGFR TKIs remains debated.

Purpose of the Study:

  • To meta-analyze the impact of BIM deletion polymorphism on the efficacy of EGFR TKIs in NSCLC patients.
  • To evaluate BIM deletion polymorphism as a predictive biomarker for EGFR TKI treatment response in NSCLC.

Main Methods:

  • Systematic literature search and screening of eligible studies.
  • Extraction and aggregation of objective response rate (ORR) and disease control rate (DCR) using odds ratios (OR).
  • Meta-analysis of progression-free survival (PFS) and overall survival (OS) using hazard ratios (HR) and random-effect models.

Main Results:

  • Fourteen studies with 2694 NSCLC patients were included.
  • BIM deletion polymorphism was associated with inferior ORR (OR=0.49) and DCR (OR=0.50).
  • Patients with BIM deletion had significantly shorter OS (HR=1.34 to 2.43) and variable PFS outcomes across subgroups.

Conclusions:

  • NSCLC patients with BIM deletion polymorphism exhibit poor response (ORR, DCR) and survival (OS) to EGFR TKIs.
  • BIM deletion polymorphism serves as a potential predictive biomarker for identifying NSCLC patients unlikely to benefit from EGFR TKIs.

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