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Updated: Jan 11, 2026
Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Assessing first-line treatment for advanced EGFR-mutated NSCLC in diverse clinicopathological subgroups: a systematic
Ting Mei1,2, Ting Wang1,2, Qinghua Zhou3,4
1Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, 610000, China.
Background:
This network meta-analysis (NMA) aimed to indicate the most effective first-line therapeutic options for advanced EGFR-mutated NSCLC, particularly considering their specific clinicopathological characteristics.
Methods:
Articles in the EMBASE, Cochrane Library, PubMed, and Web of Science databases and conference abstracts published as of December 2023, were searched to obtain data from randomized controlled trials (RCTs) of the first-line treatment of advanced EGFR-mutated NSCLC cases with EGFR-TKIs alone or together with other agents.
Results:
37 RCTs including 24 treatment regimens were incorporated into this NMA. With respect to the overall patient cohort, osimertinib + chemotherapy (CT) was associated with the greatest benefit to progression-free survival (PFS), whereas amivantamab + lazertinib yielded the greatest benefit to overall survival (OS). Osimertinib + CT yielded the best PFS outcomes irrespective of patient gender or EGFR mutation subtype. The combinations of amivantamab + lazertinib and icotinib + CT provided the best respective PFS outcomes in Asian and elderly patient cohorts. With respect to OS outcomes, afatinib + cetuximab provided the best outcomes for 19del and male cases, whereas dacomitinib provided the best OS for females and cases with L858R mutations. The respective gefitinib + CT and erlotinib + bevacizumab regimens were also associated with the greatest improvements in the OS of Asian and elderly cases.
Conclusions:
This NMA revealed that cases with EGFR-mutated NSCLC may benefit from different first-line treatment regimens according to their clinicopathological characteristics. On the whole, osimertinib plus CT and amivantamab plus lazertinib emerged as the most noticeable treatment modalities for such cases. (PROSPERO ID: CRD42024506995).
Insights
Osimertinib plus chemotherapy (CT) and amivantamab plus lazertinib are effective first-line treatments for advanced EGFR-mutated non-small cell lung cancer (NSCLC). Treatment choice depends on individual patient characteristics for optimal outcomes.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Advanced EGFR-mutated non-small cell lung cancer (NSCLC) requires effective first-line therapies.
- Tailoring treatment to specific patient clinicopathological characteristics is crucial for optimizing outcomes.
Purpose of the Study:
- To identify the most effective first-line therapeutic options for advanced EGFR-mutated NSCLC.
- To compare various treatment regimens, including EGFR-TKIs alone or in combination with other agents.
Main Methods:
- A network meta-analysis (NMA) was conducted.
- Data were sourced from 37 randomized controlled trials (RCTs) published up to December 2023.
- Searches included EMBASE, Cochrane Library, PubMed, and Web of Science databases.
Main Results:
- Osimertinib + CT showed the greatest benefit in progression-free survival (PFS) for the overall cohort.
- Amivantamab + lazertinib provided the greatest benefit in overall survival (OS).
- Specific regimens demonstrated superior outcomes for distinct subgroups (e.g., Asian, elderly, gender, mutation subtype).
Conclusions:
- First-line treatment selection for EGFR-mutated NSCLC should be individualized based on clinicopathological features.
- Osimertinib + CT and amivantamab + lazertinib are prominent treatment options.
- This NMA provides evidence for personalized therapeutic strategies in advanced NSCLC.
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