2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.12A.02 What is the Optimal First-Line Regimen for EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Network Meta-Analysis

EP.12A.02 What is the Optimal First-Line Regimen for EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Network Meta-Analysis

Back to course

Pdf Summary

This study, conducted by researchers primarily from the Shanghai Pulmonary Hospital, involved a comprehensive network meta-analysis (NMA) to evaluate the efficacy and safety of various tyrosine kinase inhibitor (TKI)-based regimens for patients with EGFR-mutated non-small cell lung cancer (NSCLC). Given the lack of direct comparisons between available regimens, the aim was to inform clinical decision-making.<br /><br />The researchers systematically reviewed data from PubMed, Embase, the Cochrane Library, and international conference databases up to April 2024. They focused on 35 randomized controlled trials (RCTs) involving a total of 9,718 individuals. The analysis compared 21 different regimens using a Bayesian framework and employed the GEMTC package with a Markov Chain Monte Carlo simulation technique.<br /><br />Key findings indicated that combination therapies based on third-generation TKIs, particularly osimertinib plus ramucirumab (OSI_RAM), provided the most significant progression-free survival (PFS) benefits across various patient subsets. While third-generation TKI combinations also exhibited superior overall survival outcomes, combinations such as erlotinib plus chemotherapy and gefitinib plus chemotherapy were ranked slightly better in specific metrics.<br /><br />In terms of safety, these third-generation TKI combinations did not significantly increase the incidence of severe adverse events, suggesting a favorable safety profile comparable to other regimens.<br /><br />The study concludes that combination regimens utilizing third-generation TKIs—such as OSI_RAM, OSI plus chemotherapy, OSI plus bevacizumab, amivantamab plus lazertinib, and aumolertinib plus apatinib—could represent a new, clinically preferable first-line standard of care for patients with advanced EGFR-mutated NSCLC.

Asset Subtitle

Wengang Zhang

Meta Tag

Speaker Wengang Zhang

Topic Metastatic Non-small Cell Lung Cancer – Targeted Therapy

Keywords

tyrosine kinase inhibitors

EGFR-mutated NSCLC

network meta-analysis

third-generation TKIs

osimertinib

progression-free survival

safety profile

randomized controlled trials

Bayesian framework

combination therapies