Meta-Analysis:
Immune checkpoint inhibitors in EGFRmutation positive TKItreated patients with advanced nonsmallcell lung cancer network metaanalysis
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Luigi Cavanna1, Chiara Citterio1 and Elena Orlandi1
1Oncology and Hematology Department, Oncology Unit, Piacenza General Hospital, Piacenza, Italy
Correspondence to:
Luigi Cavanna, email: [email protected]
Keywords: immuno-oncology; immunotherapy; NSCLC; EGFR mutation; chemotherapy
Received: November 08, 2018 Accepted: December 10, 2018 Published: January 04, 2019
ABSTRACT
Non-Small Cell Lung Cancer (NSCLC) patients with Epidermal Growth Factor Receptor (EGFR) mutation benefit from a first line of treatment with tyrosine kinase inhibitors (TKIs). After progression, the choice of treatment is between chemotherapy and immune checkpoint inhibitors, but the role of EGFR mutation in the response to immunotherapy is still unclear. A network meta-analysis was performed and 4 randomized trials comparing immune checkpoint inhibitors versus chemotherapy were identified. A Bayesian network meta-analysis was carried out to compare three checkpoint inhibitors (nivolumab, pembrolizumab and atezolizumab) versus chemotherapy (docetaxel), evaluating their Hazard Ratio (HR) and 95% Confidence Interval (CI) for Overall Survival (OS). Results suggest that patients with NSCLC and EGFR mutation, previously treated with TKIs, show better OS when treated with docetaxel in comparison to checkpoint inhibitors treatment.