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Association details:
Biomarker:EGFR mutation
Cancer:Non Small Cell Lung Cancer
Drug Class:Tyrosine kinase inhibitor
Direction:Sensitive
Evidence:
Evidence Level:
Sensitive: B - Late Trials
New
Source:
Title:

Effects of TKI on patients with non-small cell lung cancer of different stages: A meta-analysis

Excerpt:
...6 randomized control trials (RCTs) and 3 retrospective cohort studies (RCSs) of 1517 patients were included with acceptable quality, and the overall EGFR mutation rate was 66.84%. 2-year DFS were significantly improved in all the patients (HR = 0.72, 95% CI: 0.64-0.82, P < 0.01) and in the subgroup of EGFR mutant patients (HR = 0.44, 95% CI: 0.36-0.54, P < 0.01). And the difference of 5-year OS in the subgroup of EGFR mutant patients (HR = 0.54, 95% CI: 0.35-0.82, P < 0.01) was statistically significant...Stage pIIIA NSCLC patients might benefit more from adjuvant TKIs than stage pI NSCLC patients after radical resection.
DOI:
10.1200/JCO.2018.36.15_suppl.e20503
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

EGFR mutant status and tyrosine-kinase inhibitors affect the GKRS outcomes for NSCLC brain metastases

Published date:
08/17/2022
Excerpt:
There were 296 NSCLC patients with EGFR positive: TKI treatment (n = 262) and without TKI treatment (n = 34). GKRS + TKIs was more effective than GKRS alone in terms of OS (HR 0.53, p = 0.085) and DC (HR 0.51, p < 0.001)….Combining GKRS with TKIs proved effective in EGFR positive NSCLC patients...
DOI:
https://doi.org/10.1007/s11060-022-04110-8
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Local Therapy Combined With First-Line EGFR Tyrosine Kinase Inhibitor Achieves Favorable Survival in Patients With EGFR-Mutant Metastatic Non-Small Cell Lung Cancer

Published date:
02/26/2022
Excerpt:
...metastatic NSCLC patients with EGFR activating mutations who received first-line TKI and relatively radical local therapy (RRLT) were reviewed....The median PFS was 17.0 months (95% CI: 14.6-19.3), with 1-, 2-, and 3-year PFS rates of 64.1%, 31.9%, and 6.9%, respectively. The median OS was 55.0 months (95% CI: 49.3-60.6), with 1-, 3-, and 5-year OS rates of 95.4%, 64.4%, and 33.5%, respectively.
DOI:
https://doi.org/10.1177/11795549221080347
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Cell-Free Tumor DNA (ctDNA) Utility in Detection and Monitoring EGFR Mutations in Non-Small Cell Lung Cancer (NSCLC)

Published date:
08/18/2021
Excerpt:
CONTRADICTING EVIDENCE: DNA was extracted from plasma and ctDNA was analyzed for the presence of mutations in the EGFR gene using the COBAS® EGFR v2 qPCR (Roche) test….The original EGFR mutation (OM) was identified in 35 (48%) of pts at the time of enrollment with significantly higher detection rates in TKI naïve pts compared to TKI-treated group, 70% vs 37% (p=0.012). Detection of original mutation at the study baseline was negative predictor of PFS and OS (table 1).
Evidence Level:
Sensitive: C3 – Early Trials
Title:

P07.02 - Real World data of Advanced Non-Small Cell Lung Cancer Patients EGFR Mutated from a Peruvian Cohort

Published date:
08/18/2021
Excerpt:
During the study period, we analyzed the EGFR mutational status of 448 cases...Concerning treatment, 64.3% of patients (n=83) received TKI as first line and 35.7% as second or later line of treatment. The ORR was 86.8%. Median PFS was 14.13 months and median OS was 29.73 months.
Evidence Level:
Sensitive: C3 – Early Trials
Title:

A Multicenter Retrospective Study on the Prognosis of Stage III Unresectable Mutant Non-Small Cell Lung Cancer With Tyrosine Kinase Inhibitors Therapy

Published date:
07/12/2021
Excerpt:
...81 included patients had driver gene mutations, including 69 EGFR mutation (85.2%), 28 classical exon 19 deletions (34.6%), 17 exon 21 mutations (21%). In addition, there were nine ALK mutations (11.1%), one ROS (1.2%), and two HER2 mutation (2.5%)....The median progression-free survival of involved 81 patients was 13.87 months (95% confidence interval (CI): 11.66–16.08), and the median survival was 41.47 months (95%CI: 20.11–62.83)....TKIs are a viable option for mutant stage III unresectable NSCLC patients who have achieved good clinical benefit from TKI.
DOI:
https://doi.org/10.3389/fonc.2021.692703
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Mutation status and postresection survival of patients with non-small cell lung cancer brain metastasis: implications of biomarker-driven therapy

Published date:
06/04/2021
Excerpt:
…the subgroup of patients with EGFR mutation who also received tyrosine kinase inhibitor (TKI) therapy had significantly prolonged survival (HR 0.421, p = 0.0471).
DOI:
10.3171/2020.10.JNS201787
Evidence Level:
Sensitive: C3 – Early Trials
Title:

FP12.01 - Circulating Tumor DNA to the Identification of EGFR Positive NSCLC Long-Term Survivors

Published date:
01/12/2021
Excerpt:
Patients with EGFR sensitizing mutations in plasma with mutant allele frequency (MAF) <7% before treatment initiation had median OS 37.9 months (25.3-NR), compared 17.5 (95%CI: 11.3-25.5) months for patients with MAF≥7% (adjusted HR=0.43; 95%CI: 0.25-0.76, respectively). 
Evidence Level:
Sensitive: C3 – Early Trials
Title:

OA02.06 - PSM Analysis Results from REFRACT: A Multi-Center Cohort Study Investigating the Treatment Patterns in EGFR-Mutant Unresectable LA- NSCLC

Published date:
01/12/2021
Excerpt:
In patients with EGFR-mutant unresectable LA-NSCLC, first-line use of RT+TKI with or without chemotherapy was associated with the longest PFS and OS, which requires further prospective, randomized evaluation.
Trial ID:
Evidence Level:
Sensitive: C3 – Early Trials
Title:

The Clinical Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Brain Metastases from Non–Small Cell Lung Cancer-Harboring EGFR Mutations

Published date:
02/20/2020
Excerpt:
Among the 730 NSCLC patients with BM, 133 were found to have EGFR mutations, including 24.3% (33) with exon 19 deletions and 24.3% (33) with exon 21-point mutation (L858R). One patient had both exon 19 and exon 21-point mutations...Of the 133 BM cases...65 had received EGFR-TKI...treatment by TKI (HR= 1.805; 95% CI: 1.277–2.552; factors = 0.001), and NLR (HR = 1.805; 95% CI: 1.277–2.552; factors =0.001) were associated with longer OS... The results showed that pretreatment and treatment factors including age below 65, nonsmoker, high KPS, lower number of brain lesions, absence of extracranial metastases, and being treated with WBRT or EGFR-TKI were associated with a longer overall survival...
DOI:
https://doi.org/10.2147/CMAR.S250688
Evidence Level:
Sensitive: C3 – Early Trials
New
Title:

Comparative clinical outcomes for patients with advanced NSCLC harboring EGFR exon 20 insertion mutations and common EGFR mutations

Excerpt:
We conducted a retrospective cohort study to assess the clinical outcomes of EGFR exon20ins compared with common EGFR (cEGFR) mutations….The median (95% CI) rwPFS from start of the first TKI was 2.9 (2.14-3.91) months in the EGFR exon20ins cohort vs 10.5 (10.05-10.94) months in the cEGFR cohort (adjusted HR, 2.69 [2.05-3.54]; p < 0001).
DOI:
10.1016/j.lungcan.2021.10.020
Evidence Level:
Sensitive: C3 – Early Trials
New
Title:

Surgical significance and efficacy of epidermal growth factor receptor tyrosine kinase inhibitors in patients with primary lung adenosquamous carcinoma

Excerpt:
TKI treatment was associated with better median overall survival (OS) (HR=0.619; p=0.034)....ASC patients harboring EGFR-sensitizing mutations who were treated with EGFR-TKIs showed a significantly better prognosis than those receiving chemotherapy or chemoradiotherapy alone.
DOI:
10.2147/CMAR.S165660