Immunotherapy plus Chemotherapy for Patients with EGFR-Mutated Non-Squamous Cell Lung Cancer for Disease Progression...

Area of Science:

• Oncology
• Immunotherapy
• Genomics

Background:

• Non-small cell lung cancer (NSCLC) patients with EGFR mutations often experience poor outcomes after tyrosine kinase inhibitor (TKI) treatment.
• The effectiveness of combining immune checkpoint inhibitors (ICIs) with chemotherapy in this patient group remains unclear.

Purpose of the Study:

• To evaluate the efficacy of immune checkpoint inhibitors (ICIs) combined with chemotherapy in advanced NSCLC patients post-EGFR TKI progression.
• To analyze progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) in this population.

Main Methods:

• A systematic search was conducted for randomized controlled trials (RCTs) of ICIs plus chemotherapy in advanced NSCLC patients after EGFR TKI progression.
• Data on PFS, OS, and ORR were extracted and analyzed from six included studies, totaling 2,225 patients.

Main Results:

• The combination therapy significantly improved PFS (HR = 0.60; p < 0.0001).
• Patients with prior third-generation TKI exposure demonstrated a more pronounced PFS benefit (HR = 0.61; p < 0.0001), while those without prior exposure showed no benefit.
• Significant improvements were also observed in OS (HR = 0.87; p = 0.04) and ORR (OR = 1.91; p < 0.0001).

Conclusions:

• Immune checkpoint inhibitors (ICIs) combined with chemotherapy offer significant PFS benefits for EGFR-mutated NSCLC patients who have progressed on TKI therapy.
• Stratifying patients based on prior treatment exposure, particularly to third-generation TKIs, is crucial for optimizing therapeutic strategies and future research.