EGFR Inhibitors for Lung Cancer: Canadian Guidelines
Author Information
Author(s): Ellis P.M. MD, PhD, Morzycki W. MD, Melosky B. MD, Butts C. MD, Hirsh V. MD, Krasnoshtein F. MSc, Murray N. MD, Shepherd F.A. MD, Soulieres D. MD, Tsao M.S. MD, Goss G. MD
Primary Institution: Juravinski Cancer Centre, Hamilton, ON
Hypothesis
What is the role of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced or metastatic non-small-cell lung cancer (NSCLC)?
Conclusion
EGFR-TKIs represent an additional therapy in the treatment of advanced or metastatic NSCLC, but their optimal role is still being defined.
Supporting Evidence
- EGFR-TKIs should not be used with platinum-based chemotherapy as first-line therapy.
- Single-agent EGFR-TKIs have variable response rates in unselected populations.
- Quality of life improvements were noted with EGFR-TKIs compared to second-line chemotherapy.
Takeaway
Doctors are trying to figure out the best way to use new medicines for lung cancer, but they found that some treatments might not work well together.
Methodology
A systematic literature search was conducted to identify relevant phase II and III trials and meta-analyses.
Potential Biases
Potential bias due to the selection of trials and the focus on response rates rather than survival.
Limitations
The evidence is insufficient to recommend first-line single-agent EGFR-TKI therapy in unselected populations.
Participant Demographics
Patients included were primarily those with advanced or metastatic NSCLC, with varying performance statuses.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI: 0.85 to 1.65
Statistical Significance
p<0.05
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