The impact of both platinum-based chemotherapy and EGFR-TKIs on overall survival of patients with advanced non-small cell lung cancer

Jian Wei Zhang, Yuan Yuan Zhao, Ying Guo, Cong Xue, Zhi Huang Hu, Yan Huang, Hong Yun Zhao, Jing Zhang, Xuan Wu, Wen Feng Fang, Yu Xiang Ma, Li Zhang

    Research output: Contribution to journalArticle

    7 Scopus citations

    Abstract

    Both platinum-based doublet chemotherapy (PBC) and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) prolong the survival of patients with advanced non-small cell lung cancer (NSCLC). In early studies, most patients underwent PBC as first-line treatment, but not all patients could afford EGFR-TKIs as second-line treatment. To understand the impact of PBC and EGFR-TKIs on NSCLC prognosis, we evaluated the association between the receipt of both regimens and overall survival (OS). Using MEDLINE and EMBASE, we identified prospective, randomized, controlled phase III clinical trials in advanced NSCLC that met the inclusion criteria: in general population with advanced NSCLC, the percentage of patients treated with both PBC and EGFR-TKIs was available in the trial and OS was reported. After collecting data from the selected trials, we correlated the percentage of patients treated with both PBC and EGFR-TKIs with the reported OS, using a weighted analysis. Fifteen phase III clinical trials-involving 11,456 adult patients in 32 arms-were included in the analysis, including 6 trials in Asian populations and 9 in non-Asian (predominantly Caucasian) populations. The OS was positively correlated with the percentage of patients treated with both PBC and EGFR-TKIs (r = 0.797, P < 0.001). The correlation was obvious in the trials in Asian populations (r = 0.936, P < 0.001) but was not statistically significant in the trials in predominantly Caucasian populations (r = 0.116, P = 0.588). These results suggest that treatment with PBC and EGFR-TKIs may provide a survival benefit to patients with advanced NSCLC, highlighting the importance of having both modalities available for therapy.

    Original languageEnglish (US)
    Pages (from-to)105-114
    Number of pages10
    JournalChinese journal of cancer
    Volume33
    Issue number2
    DOIs
    StatePublished - Feb 7 2014

    Keywords

    • Correlation
    • EGFR-TKIs
    • NSCLC
    • Overall survival
    • Platinum-based doublet chemotherapy

    ASJC Scopus subject areas

    • Oncology

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  • Cite this

    Zhang, J. W., Zhao, Y. Y., Guo, Y., Xue, C., Hu, Z. H., Huang, Y., Zhao, H. Y., Zhang, J., Wu, X., Fang, W. F., Ma, Y. X., & Zhang, L. (2014). The impact of both platinum-based chemotherapy and EGFR-TKIs on overall survival of patients with advanced non-small cell lung cancer. Chinese journal of cancer, 33(2), 105-114. https://doi.org/10.5732/cjc.012.10274