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First-line treatment for advanced or metastatic EGFR mutation-positive non-squamous non-small cell lung cancer: a

Mengyao Zhang1, Lan Sun1

  • 1Department of Oncology, Bishan Hospital of Chongqing Medical University, Chongqing, China.

Frontiers in Oncology
|January 30, 2025
PubMed
Abstract

Insights

Osimertinib is the preferred first-line treatment for EGFR M+ non-small cell lung cancer, offering superior survival benefits, especially when combined with chemotherapy. Further research is needed to validate these findings.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Advanced or metastatic non-squamous non-small cell lung cancer (nsq-NSCLC) with EGFR mutations requires effective first-line treatments.
  • Existing meta-analyses lack a comprehensive comparison of multiple treatment strategies.
  • Network meta-analysis is needed to evaluate diverse treatment modalities for EGFR M+ nsq-NSCLC.

Purpose of the Study:

  • To conduct a network meta-analysis comparing efficacy and safety of first-line treatments for EGFR M+ advanced/metastatic nsq-NSCLC.
  • To enable direct and indirect comparisons of various treatment strategies.
  • To provide a thorough assessment of treatment options.

Main Methods:

  • Systematic search of PubMed, Embase, Cochrane Library, and Web of Science databases until May 8, 2024.
  • Inclusion of 30 randomized controlled trials (RCTs) with 8654 participants.
  • Primary endpoints: progression-free survival (PFS) and overall survival (OS); Secondary outcomes: objective response rate (ORR) and grade 3+ adverse events (≥3AEs).

Main Results:

  • Osimertinib + Chemotherapy (SUCRAs: 93.4%) and Osimertinib (SUCRAs: 84.61%) showed superior PFS.
  • Lazertinib (SUCRAs: 89.72%), Gefitinib (SUCRAs: 72.07%), and Osimertinib + Chemotherapy (SUCRAs: 70.74%) were top for OS.
  • Afatinib demonstrated the best ORR (SUCRAs: 92.27%) and was a favorable choice for ≥3AEs (SUCRAs: 74.93%).

Conclusions:

  • Osimertinib is a preferred first-line treatment for untreated EGFR M+ advanced/metastatic nsq-NSCLC, balancing survival and safety.
  • Combination of Osimertinib with chemotherapy offers enhanced survival benefits.
  • Further high-quality research is recommended due to study limitations.
Keywords:
EGFR mutation-positivefirst-line treatmentnetwork meta-analysisnon-small cell lung cancernon-squamous

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