Abstract 222P
Background
Adjuvant platinum-based chemotherapy proved to add limited survival benefits in completely resected EGFR-mutated lung cancer undergoing adjuvant Osimertinib. Indeed, efficacy of adjuvant chemotherapy in this selected population has been poorly investigated. To enlighten the role of chemotherapy in these patients, we conducted an Individual Patient Data (IPD) meta-analysis of phase III trials to compare survival outcomes of the EGFR mutated lung cancer undergoing chemotherapy versus placebo.
Methods
An IPD meta-analysis of phase III trials was conducted including studies evaluating the adjuvant treatment strategies in EGFR mutated lung cancer. IPD was extracted using the IPDfromKM method from available Kaplan Meier curves estimated from the intention to treat analysis. Primary outcome of the analysis was to compare disease-free survival (DFS) of those undergoing chemotherapy without tyrosine-kinase inhibitors to those undergoing placebo. Overall survival (OS) was secondarily assessed. Hazard ratios (HR) and relative 95% confidence intervals (95% CI) were estimated with Cox regression analyses.
Results
Data from 538 and 143 patients with EGFR mutated lung cancer undergoing either chemotherapy or placebo were retrieved from five randomized controlled trial. IPD for EGFR-mutated lung cancer patients treated with chemotherapy were retrieved from ADJUVANT/CTONG, EVIDENCE, IMPACT and ADAURA trials while IPD for those treated with placebo were retrieved from ICTAN and ADAURA trials. Recurrence or death happened in 386 patients. The 3-yr DFS were 37% in the chemotherapy group and 32.2% in the placebo group. The HR for DFS was 0.9 (95% CI 0.71–1.1; p=0.377). Death was recorded in 131 patients. The 3-yr OS were 82.8% in the chemotherapy group and 81.2% in the placebo group. The HR for OS was 0.85 (95% CI 0.57–1.27; p=0.421).
Conclusions
Our analysis showed that adjuvant chemotherapy has limited effect on recurrence risk in radically resected stage II-IIIA EGFR-mutated lung cancer.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.