A systematic review and network meta-analysis of first-line EGFR-TKI-based combination strategies for EGFR-mutant non-small cell lung cancer with brain metastases.
Jiayun Ma, Weixing Zhao, Wanjing Guo et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated the efficacy and safety of first-line EGFR-TKI-based combination strategies in patients with EGFR-mutant non-small cell lung cancer and brain metastases. The analysis included 48 studies with 5,432 patients. EGFR-TKI plus anti-angiogenic therapy showed a significant overall survival benefit (HR, 0.63), while EGFR-TKI plus chemotherapy demonstrated superior progression-free survival (HR, 0.52) and intracranial progression-free survival (HR, 0.36).
Key findings
- EGFR-TKI plus anti-angiogenic therapy improved overall survival (HR, 0.63; 95% CI, 0.49-0.80) compared to monotherapy.
- EGFR-TKI plus chemotherapy provided the best progression-free survival (HR, 0.52; 95% CI, 0.44-0.61).
- EGFR-TKI plus chemotherapy also showed the most favorable intracranial progression-free survival (HR, 0.36; 95% CI, 0.25-0.52).
- RCT-only analyses consistently supported the PFS benefit of EGFR-TKI plus chemotherapy.
Why it matters
Understanding the relative efficacy of EGFR-TKI-based combinations is crucial for optimizing treatment strategies in patients with EGFR-mutant NSCLC and brain metastases, a population with significant clinical challenges.