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Poster Display

2556 - Intercalated combination of chemotherapy and epidermal growth factor receptor inhibitors for patients with advanced non-small-cell lung cancer: A systematic review and meta-analysis

Date

08 Oct 2016

Session

Poster Display

Presenters

Antonio Rossi

Citation

Annals of Oncology (2016) 27 (6): 416-454. 10.1093/annonc/mdw383

Authors

A. Rossi1, A. La Salvia2, D. Galetta3, E. Gobbini4, E. De Luca2, S. Novello4, M. Di Maio2

Author affiliations

  • 1 Division Of Medical Oncology, Azienda Ospedaliera S. Giuseppe Moscati, 83100 - Avellino/IT
  • 2 Department Of Oncology, Azienda Ospedaliero-Universitaria ASOU San Luigi Gonzaga, Orbassano/IT
  • 3 Medical Oncology Department, Istituto Tumori Giovanni Paolo II, 70124 - Bari/IT
  • 4 Department Of Oncology, Azienda Ospedaliero-Universitaria ASOU San Luigi Gonzaga, 10043 - Orbassano/IT
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Resources

Abstract 2556

Background

Trials investigating the efficacy of EGFR-tyrosine kinase inhibitors (TKIs) in combination with chemotherapy in unselected patients with advanced non-small-cell lung cancer (NSCLC) showed negative results. Preclinical data suggest that the intercalated administration could be effective. The aim of our study was to perform a systematic review and meta-analysis of randomized trials (RCTs) testing the addition of intercalated EGFR-TKIs to chemotherapy in patients with advanced NSCLC.

Methods

A systematic review of articles published or presented at major meetings was performed in December 2015. RCTs comparing CT + intercalated EGFR TKI vs. CT alone in pts with advanced NSCLC were included. The primary outcome measure was overall survival (OS); secondary outcomes were progression-free survival (PFS), objective response rate (ORR) and toxicity.

Results

9 RCTs were eligible (5 with erlotinib, 4 with gefitinib): 37% of patients had known EGFR mutational status, and 46% were EGFR mutation-positive. Intercalated combination was associated with a significant improvement in OS (Hazard Ratio [HR] 0.83, 95%CI 0.72-0.97, p = 0.02), PFS (HR 0.60, 95%CI 0.53-0.68, p 

Conclusions

The addition of intercalated EGFR-TKI to chemotherapy is associated with a significant benefit in OS, PFS and objective response rate in patients with advanced NSCLC, although a definitive interpretation is jeopardized by the variable proportion of patients with EGFR mutation-positive tumors included.

Clinical trial identification

Legal entity responsible for the study

University of Turin

Funding

University of Turin

Disclosure

A. Rossi: Honoraria as speaker bureau for Roche, BoehringerIngelheim, AstraZeneca, and advisory board member for AstraZeneca and Eli-Lilly. D. Galetta: Advisory board member for BoehringerIngelheim and Eli-Lilly. S. Novello: Honoraria as speaker bureau for Roche, BoehringerIngelheim, AstraZeneca, and Eli-Lilly. M. Di Maio: Honoraria as speaker bureau for BoehringerIngelheim, AstraZeneca, Eli-Lilly and advisory board member for AstraZeneca and Eli-Lilly. All other authors have declared no conflicts of interest.

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