Limits...
Different efficacy of EGFR tyrosine kinase inhibitors and prognosis in patients with subtypes of EGFR-mutated advanced non-small cell lung cancer: a meta-analysis.

Wang H, Huang J, Yu X, Han S, Yan X, Sun S, Zhu X - J. Cancer Res. Clin. Oncol. (2014)

Bottom Line: In addition, we used variance analysis for the progression-free survival data (PFS) and used the rank sum test for the overall survival data.The PFS (MD 3.55; 95 % CI 0.90-6.20; P = 0.009; MD 2.57; 95 % CI 0.51-4.62; P = 0.01) and overall survival (OS) (MD 10.52; 95 % CI 5.10-15.93; P = 0.0001) of the 19del mutation group were significantly longer than the 21L858R mutation group; the same results were observed in the variance analysis and rank sum test.Furthermore, patients with the 19del mutation have both a longer PFS and OS.

View Article: PubMed Central - PubMed

Affiliation: Medical School of Southeast University, Nanjing, China. Zhongda Hospital of Southeast University, Dingjiaqiao 87,Gulou District, Nanjing 210009, China

ABSTRACT

Background: Nearly 85 % of lung-cancer-specific epidermal growth factor receptor (EGFR) sensitive mutations comprise a substitution at position 858 (21L858R) and deletion mutants in exon 19 (19del). The aim of this study was to assess the role of EGFR mutation subtypes in predicting the efficacy of EGFR tyrosine kinase inhibitors (EGFR TKIs) and the prognosis of patients with advanced non-small cell lung cancer (NSCLC).

Method: We systematically searched for eligible articles investigating the association between EGFR mutation subtypes and the efficacy of EGFR TKIs and the prognosis of patients with NSCLC. The summary risk ratio (RR) and mean difference (MD) were calculated using meta-analysis. In addition, we used variance analysis for the progression-free survival data (PFS) and used the rank sum test for the overall survival data.

Results: We identified 22 eligible trials involving 1,082 patients. The objective response rate of the 19del mutation group was significantly higher than the 21L858R mutation group (RR 1.23; 95 % CI 1.12-1.36; P < 0.0001). The PFS (MD 3.55; 95 % CI 0.90-6.20; P = 0.009; MD 2.57; 95 % CI 0.51-4.62; P = 0.01) and overall survival (OS) (MD 10.52; 95 % CI 5.10-15.93; P = 0.0001) of the 19del mutation group were significantly longer than the 21L858R mutation group; the same results were observed in the variance analysis and rank sum test.

Conclusion: The 19del mutation may be a more efficient clinical marker for predicting the response of patients with NSCLC to EGFR TKIs. Furthermore, patients with the 19del mutation have both a longer PFS and OS. The 19del mutation is also the prognostic factor for patients with NSCLC.

Show MeSH

Related in: MedlinePlus

Forest plot of OS among patients with EGFR 19del or 21L858R mutations. The squares and horizontal lines correspond to the study-specific MD and 95 % CI. The area of the squares reflects the weight
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4196046&req=5

Fig5: Forest plot of OS among patients with EGFR 19del or 21L858R mutations. The squares and horizontal lines correspond to the study-specific MD and 95 % CI. The area of the squares reflects the weight

Mentions: Data for the OS were available in three of the retrospective trials. The standard deviation for the OS could be obtained in Xu’s trial. But it was necessary to set the value for the other two trials. The I2 statistic in the fixed effects model did not demonstrate significant heterogeneity in the results (I2 0 %; P = 0.42), so the fixed effects model was used to pool the mean difference for the included studies. As shown in Fig. 5, patients with exon 19del mutation had a statistically significant longer OS than patients with exon 21L858R mutation (MD 10.52; 95 % CI: 5.10–15.93; P = 0.0001).Fig. 5


Different efficacy of EGFR tyrosine kinase inhibitors and prognosis in patients with subtypes of EGFR-mutated advanced non-small cell lung cancer: a meta-analysis.

Wang H, Huang J, Yu X, Han S, Yan X, Sun S, Zhu X - J. Cancer Res. Clin. Oncol. (2014)

Forest plot of OS among patients with EGFR 19del or 21L858R mutations. The squares and horizontal lines correspond to the study-specific MD and 95 % CI. The area of the squares reflects the weight
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4196046&req=5

Fig5: Forest plot of OS among patients with EGFR 19del or 21L858R mutations. The squares and horizontal lines correspond to the study-specific MD and 95 % CI. The area of the squares reflects the weight
Mentions: Data for the OS were available in three of the retrospective trials. The standard deviation for the OS could be obtained in Xu’s trial. But it was necessary to set the value for the other two trials. The I2 statistic in the fixed effects model did not demonstrate significant heterogeneity in the results (I2 0 %; P = 0.42), so the fixed effects model was used to pool the mean difference for the included studies. As shown in Fig. 5, patients with exon 19del mutation had a statistically significant longer OS than patients with exon 21L858R mutation (MD 10.52; 95 % CI: 5.10–15.93; P = 0.0001).Fig. 5

Bottom Line: In addition, we used variance analysis for the progression-free survival data (PFS) and used the rank sum test for the overall survival data.The PFS (MD 3.55; 95 % CI 0.90-6.20; P = 0.009; MD 2.57; 95 % CI 0.51-4.62; P = 0.01) and overall survival (OS) (MD 10.52; 95 % CI 5.10-15.93; P = 0.0001) of the 19del mutation group were significantly longer than the 21L858R mutation group; the same results were observed in the variance analysis and rank sum test.Furthermore, patients with the 19del mutation have both a longer PFS and OS.

View Article: PubMed Central - PubMed

Affiliation: Medical School of Southeast University, Nanjing, China. Zhongda Hospital of Southeast University, Dingjiaqiao 87,Gulou District, Nanjing 210009, China

ABSTRACT

Background: Nearly 85 % of lung-cancer-specific epidermal growth factor receptor (EGFR) sensitive mutations comprise a substitution at position 858 (21L858R) and deletion mutants in exon 19 (19del). The aim of this study was to assess the role of EGFR mutation subtypes in predicting the efficacy of EGFR tyrosine kinase inhibitors (EGFR TKIs) and the prognosis of patients with advanced non-small cell lung cancer (NSCLC).

Method: We systematically searched for eligible articles investigating the association between EGFR mutation subtypes and the efficacy of EGFR TKIs and the prognosis of patients with NSCLC. The summary risk ratio (RR) and mean difference (MD) were calculated using meta-analysis. In addition, we used variance analysis for the progression-free survival data (PFS) and used the rank sum test for the overall survival data.

Results: We identified 22 eligible trials involving 1,082 patients. The objective response rate of the 19del mutation group was significantly higher than the 21L858R mutation group (RR 1.23; 95 % CI 1.12-1.36; P < 0.0001). The PFS (MD 3.55; 95 % CI 0.90-6.20; P = 0.009; MD 2.57; 95 % CI 0.51-4.62; P = 0.01) and overall survival (OS) (MD 10.52; 95 % CI 5.10-15.93; P = 0.0001) of the 19del mutation group were significantly longer than the 21L858R mutation group; the same results were observed in the variance analysis and rank sum test.

Conclusion: The 19del mutation may be a more efficient clinical marker for predicting the response of patients with NSCLC to EGFR TKIs. Furthermore, patients with the 19del mutation have both a longer PFS and OS. The 19del mutation is also the prognostic factor for patients with NSCLC.

Show MeSH
Related in: MedlinePlus