Comparison of up-front radiotherapy and TKI with TKI alone for NSCLC with brain metastases and EGFR mutation: A meta-analysis

Lung Cancer : Journal of the International Association for the Study of Lung Cancer
Chunyu WangLuhua Wang

Abstract

About 50-70% non-small cell lung cancer (NSCLC) patients with EGFR mutation go through brain metastases (BM). Radiotherapy is the standard treatment before the tyrosine kinase inhibitor (TKI) era. However, the TKI has more than 70% intracranial response rate. Here, we performed a meta-analysis to compare clinical outcomes of up-front radiotherapy and TKI with TKI alone for NSCLC with BM and EGFR mutations. We searched Embase, Pubmed, Web of Science, Medline, the Cochrane Library and important oncology meetings comparing the up-front radiotherapy (RT) and TKI with TKI alone in NSCLC patients with newly diagnosed BM and EGFR mutation from database inception to December 2017. We conducted meta-analyses evaluating intracranial progression-free survival (iPFS) and overall survival (OS) with hazard ratios (HR) and 95% confidence intervals (CI) based on the HR of individual study. Seven studies with 1086 patients were eligible for meta-analyses. Compared to TKI alone, up-front RT and TKI showed better iPFS (HR = 0.72, 95%CI: 0.53-0.97, p = 0.028) and OS (HR = 0.70, 95%CI 0.53-0.93, p = 0.015). Meta regression analyses and subgroup analyses demonstrated patients with limited number of brain metastases benefited more from up-front RT on...Continue Reading

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Citations

Apr 10, 2020·Journal of Neurosurgical Sciences·Boryana M EastmanJerome J Graber
Dec 10, 2019·Journal of Cancer Research and Clinical Oncology·Wang Li, Hong Yu
Oct 23, 2019·Case Reports in Oncological Medicine·Néstor Llinás-QuinteroJavier Cuello-López
Jan 14, 2021·International Journal of Molecular Sciences·Agnieszka Rybarczyk-KasiuchniczKatarzyna Stencel
Nov 14, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Markus GlatzerPaul M Putora
May 28, 2019·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·N GiraudR Trouette
Nov 9, 2021·Frontiers in Oncology·Guixiang LiaoMuhammad Khan

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