ASTRO 2017: Chemotherapy Plus EGFR Tyrosine Kinase Inhibitors in NSCLC
Compared with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors alone, the combination of EGFR tyrosine kinase inhibitors and chemotherapy improved progression-free survival and may be considered a safe and effective treatment choice for patients with advanced non–small cell lung cancer (NSCLC) with EGFR-activating mutations. Guang Han, MD, of Renmin Hospital of Wuhan University, Wuhan, China, presented these findings at the 2017 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 3088) and believe further well-designed randomized trials are warranted to validate them.
Targeted therapy based on the presence of EGFR mutations is becoming standard practice in patients with advanced NSCLC. However, the debate over the superiority of EGFR tyrosine kinase inhibitors in combination with chemotherapy versus these inhibitors alone continues.
The researchers conducted a meta-analysis of 5 studies comprising of 862 patients. The combination of EGFR tyrosine kinase inhibitors and chemotherapy improved progression-free survival in NSCLC patients with EGFR-activating mutations. However, they did not observe a significant difference between the two arms in overall response rate and overall survival. The incidence of grade 3 or 4 adverse events was low and similar between the two arms.
In a subgroup analysis, it appeared the combination therapy may improve progression-free survival in Asian patients, but white patients may not obtain the same benefit from this therapy.