- Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with an antiangiogenic drug offered significantly better PFS in patients with EGFR-mutated NSCLC compared with EGFR-TKIs alone, although the incidence of grade ≥3 adverse events (AEs) was significantly greater.
Why this matters
- Previous studies comparing combination therapy with monotherapy yielded conflicting results.
- Systematic review and meta-analysis of 5 RCTs of EGFR-TKIs alone or with an antiangiogenic drug in patients with advanced NSCLC.
- Network meta-analysis (NMA) of 10 RCTs of first-generation EFGR-TKIs alone vs an experimental therapy (first-generation EGFR-TKI plus an antiangiogenic drug, first-generation EGFR-TKI plus chemotherapy; or second- or third-generation EGFR-TKI alone) in patients with advanced NSCLC.
- Funding: None.
- Combination therapy was associated with significantly better PFS than EGFR-TKI alone (pooled HR, 0.59; 95% CI, 0.51-0.69), but there was no difference in OS.
- Median PFS:
- 17.8 (95% CI, 16.5-19.3) months for combination therapy.
- 11.7 (95% CI, 11.1-12.7) months for EGFR-TKI alone.
- Combination therapy was associated with significantly higher rate of grade ≥3 AEs than monotherapy:
- Relative risk, 1.72 (95% CI, 1.43-2.06).
- NMA found all experimental therapies offered better PFS than first-generation EFGR-TKI alone.
- No difference in PFS among the 3 experimental therapies.
- None included.