Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis

Background. Tyrosine kinase inhibitors (TKIs) are the standard of treatment of EGFR-positive metastatic non-small cell lung cancer (mNSCLC). Different TKI generations have different properties. Currently there are no results of head-to-head clinical trials of II generation TKI afatinib against III g...

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Autor principal:	Sergey V. Goryaynov
Formato:	article
Lenguaje:	RU
Publicado:	IP Habib O.N. 2021
Materias:	lung cancer tyrosine kinase inhibitors survival afatinib osimertinib Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/0aa41362529a4035b643c0a792aa4083
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spelling	oai:doaj.org-article:0aa41362529a4035b643c0a792aa40832021-11-30T16:55:01ZComparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis1815-14341815-144210.26442/18151434.2021.3.201111https://doaj.org/article/0aa41362529a4035b643c0a792aa40832021-11-01T00:00:00Zhttps://modernonco.orscience.ru/1815-1434/article/viewFile/81186/61654https://doaj.org/toc/1815-1434https://doaj.org/toc/1815-1442Background. Tyrosine kinase inhibitors (TKIs) are the standard of treatment of EGFR-positive metastatic non-small cell lung cancer (mNSCLC). Different TKI generations have different properties. Currently there are no results of head-to-head clinical trials of II generation TKI afatinib against III generation TKI osimertinib. In such case network meta-analysis (NMA) can be used for evidence synthesis. Aim. To compare afatinib and osimertinib effect on overall survival (OS) in first-line drug treatment of EGFR-positive mNSCLC. Materials and methods. Search of trials to build evidence network was done in Medline, CT.gov, and EU-CTR. Endpoint was OS measured as hazard ratio (HR) of all-cause death. Analysis was split into base case analysis and two sensitivity analyses depending on criteria of transitivity. Random effect model was used for NMA. Results were analyzed in overall population and subgroups according to the type of EGFR-mutation, ECOG score, and presence of CNS metastases. Statistical analysis was done in R with netmeta package. Results. Fourteen trials were included in the study. There was no statistically significant difference regarding OS between afatinib and osimertinib in overall population neither in base case nor in first sensitivity analysis: HR 1.06 [0.79; 1.41], p=0.697 and 1.08 [0.83; 1.41], p=0.561, respectively. Results of comparison of II generation TKIs against osimertinib in second sensitivity analysis were consistent: HR 1.03 [0.81; 1.31], p=0.834. Results in all subgroups were consistent with each other and overall population. There was no statistically significant heterogeneity/inconsistency in the network in any of the analyses. Conclusion. Afatinib and osimertinib have similar efficacy regarding OS in first-line drug treatment of EGFR-positive mNSCLC.Sergey V. GoryaynovIP Habib O.N.articlelung cancertyrosine kinase inhibitorssurvivalafatinibosimertinibNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282RUСовременная онкология, Vol 23, Iss 3, Pp 408-417 (2021)
institution	DOAJ
collection	DOAJ
language	RU
topic	lung cancer tyrosine kinase inhibitors survival afatinib osimertinib Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	lung cancer tyrosine kinase inhibitors survival afatinib osimertinib Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Sergey V. Goryaynov Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis
description	Background. Tyrosine kinase inhibitors (TKIs) are the standard of treatment of EGFR-positive metastatic non-small cell lung cancer (mNSCLC). Different TKI generations have different properties. Currently there are no results of head-to-head clinical trials of II generation TKI afatinib against III generation TKI osimertinib. In such case network meta-analysis (NMA) can be used for evidence synthesis. Aim. To compare afatinib and osimertinib effect on overall survival (OS) in first-line drug treatment of EGFR-positive mNSCLC. Materials and methods. Search of trials to build evidence network was done in Medline, CT.gov, and EU-CTR. Endpoint was OS measured as hazard ratio (HR) of all-cause death. Analysis was split into base case analysis and two sensitivity analyses depending on criteria of transitivity. Random effect model was used for NMA. Results were analyzed in overall population and subgroups according to the type of EGFR-mutation, ECOG score, and presence of CNS metastases. Statistical analysis was done in R with netmeta package. Results. Fourteen trials were included in the study. There was no statistically significant difference regarding OS between afatinib and osimertinib in overall population neither in base case nor in first sensitivity analysis: HR 1.06 [0.79; 1.41], p=0.697 and 1.08 [0.83; 1.41], p=0.561, respectively. Results of comparison of II generation TKIs against osimertinib in second sensitivity analysis were consistent: HR 1.03 [0.81; 1.31], p=0.834. Results in all subgroups were consistent with each other and overall population. There was no statistically significant heterogeneity/inconsistency in the network in any of the analyses. Conclusion. Afatinib and osimertinib have similar efficacy regarding OS in first-line drug treatment of EGFR-positive mNSCLC.
format	article
author	Sergey V. Goryaynov
author_facet	Sergey V. Goryaynov
author_sort	Sergey V. Goryaynov
title	Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis
title_short	Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis
title_full	Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis
title_fullStr	Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis
title_full_unstemmed	Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis
title_sort	comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of egfr-positive metastatic non-small cell lung cancer: network meta-analysis
publisher	IP Habib O.N.
publishDate	2021
url	https://doaj.org/article/0aa41362529a4035b643c0a792aa4083
work_keys_str_mv	AT sergeyvgoryaynov comparisonofafatinibandosimertinibeffectonoverallsurvivalinfirstlinedrugtreatmentofegfrpositivemetastaticnonsmallcelllungcancernetworkmetaanalysis
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Comparison of afatinib and osimertinib effect on overall survival in first-line drug treatment of EGFR-positive metastatic non-small cell lung cancer: network meta-analysis

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