Does tyrosine kinase inhibitors therapy after surgery benefit patients with EGFR-mutant resected NSCLC?

This study evaluated whether patients with non-small-cell lung cancer (NSCLC) having genetic mutations could benefit from epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) therapy after surgery. The data showed that EGFR-TKI therapy after surgery significantly improved survival without disease progression in these patients.

NSCLC is the most common form of lung cancer. NSCLC is responsible for around 85% of all lung cancer diagnoses. Standard treatment for advanced NSCLC involves surgical removal of solid tumors and chemotherapy. Cisplatin (Platinol)-based chemotherapy was previously considered as the standard therapy for improved overall survival in patients with NSCLC after surgery. However, the benefit was limited due to the high risks of recurrence and side effects.

Genetic mutations (changes) in the EGFR gene can lead to NSCLC. EGFR-TKIs such as gefitinib (Iressa) and erlotinib (Tarceva) are targeted therapies that block these mutations. This causes cancer cells to stop growing and spreading. They have been shown to improve survival outcomes and quality of life for patients with advanced NSCLC. However, whether EGFR-TKIs are effective for the treatment of EGFR-mutant patients after surgery is still unclear.

This study analyzed 7 studies involving a total of 1283 patients with resectable NSCLC who had mutations in the EGFR gene. In these studies, patients received either EGFR-TKIs targeted therapy, chemotherapy or a placebo after surgery.

Patients who received EGFR-TKIs after surgery had a significantly (by 59%) higher chance of survival without disease progression compared to those who received chemotherapy or placebo.

Patients who received EGFR-TKIs after surgery were associated with a 28% higher chance of survival compared to those who received chemotherapy or placebo. This benefit was not significant.

EGFR-TKIs after surgery reduced the risk of bone (by 60%) and lung relapse (by 49%), without significantly decreasing the risk of local recurrence (by 27%) and liver relapse (by 57%).

Patients who received osimertinib (Tagrisso) after surgery were associated with an 80% higher chance of survival without disease progression compared to those who received gefitinib or erlotinib. Osimertinib also reduced the risk of brain recurrence by 89% compared to gefitinib or erlotinib.

Overall, 14.09% of the patients treated with EGR-TKIs experienced severe side effects. The most common side effects were rash, diarrhea, vomiting, pneumonia, and fatigue.

This study concluded that EGFR-TKI targeted therapy after surgery significantly improved survival without disease progression in patients with resected EGFR-mutant NSCLC. Treatment with osimertinib showed improved survival with a lower risk of brain recurrence than treatment with gefitinib or erlotinib.

The data were collected from published studies rather than from each individual patient. Important patient information such as smoking history, cancer stage, and EGFR mutation status was missing.