Meta‐analysis of first‐line therapies with maintenance regimens for advanced non‐small‐cell lung cancer (NSCLC) in molecularly and clinically selected populations

Abstract

Evidence has suggested survival benefits of maintenance for advanced NSCLC patients not progressing after first‐line chemotherapy. Additionally, particular first‐line targeted therapies have shown survival improvements in selected populations. Optimal first‐line and maintenance therapies remain unclear. Here, currently available evidence was synthesized to elucidate optimal first‐line and maintenance therapy within patient groups. Literature was searched for randomized trials evaluating first‐line and maintenance regimens in advanced NSCLC patients. Bayesian network meta‐analysis was performed within molecularly and clinically selected groups. The primary outcome was combined clinically meaningful OS and PFS benefits. A total of 87 records on 56 trials evaluating first‐line treatments with maintenance were included. Results showed combined clinically meaningful OS and PFS benefits with particular first‐line with maintenance treatments, (1) first‐line intercalated chemotherapy+erlotinib, maintenance erlotinib in patients with EGFR mutations, (2) first‐line afatinib, maintenance afatinib in patients with EGFR deletion 19, (3) first‐line chemotherapy + bevacizumab, maintenance bevacizumab in EGFR wild‐type patients, (4) chemotherapy+conatumumab, maintenance conatumumab in patients with squamous histology, (5) chemotherapy+cetuximab, maintenance cetuximab or chemotherapy + necitumumab, maintenance necitumumab in EGFR FISH‐positive patients with squamous histology, and (6) first‐line chemotherapy+bevacizumab, maintenance bevacizumab or first‐line sequential chemotherapy+gefitinib, maintenance gefitinib in patients clinically enriched for EGFR mutations with nonsquamous histology. No treatment showed combined clinically meaningful OS and PFS benefits in patients with EGFR L858R or nonsquamous histology. Particular first‐line with maintenance treatments show meaningful OS and PFS benefits in patients selected by EGFR mutation or histology. Further research is needed to achieve effective therapy for patients with EGFR mutation L858R or nonsquamous histology.

Development of a nanoliposomal formulation of erlotinib for lung cancer and in vitro/in vivo antitumoral evaluation

“…It reversibly binds the binding site of ATP in the epidermal growth factor receptor tyrosine kinase domain to inhibit the automatic phosphorylation of tyrosine kinases. 1 , 2 Inhibition of tyrosine kinase can promote apoptosis, inhibit angiogenesis, and ultimately prevent excessive cell proliferation. 3 – 5 Erlotinib in treatment of various solid tumors such as non-small-cell lung cancer is available in oral form.…”

HA/HSA co-modified erlotinib–albumin nanoparticles for lung cancer treatment

“…The test drug administration procedures were as follows: Day 0, Day 3, Day 9, Day 12, and euthanasia on Day 30. A digital caliper was used to measure the tumor diameters (in millimeters), and tumor volumes (in cubic millimeters) were calculated using the following formula: tumor volume=length×width 2 ×0.5. In the course of the study, mice were regularly weighed to monitor the potential toxicities.…”

“…It reversibly binds the binding site of ATP in the epidermal growth factor receptor tyrosine kinase domain to inhibit the automatic phosphorylation of tyrosine kinases. 1 , 2 Inhibition of tyrosine kinase promotes cell apoptosis, inhibits angiogenesis, and ultimately prevents proliferation of cells. 3 – 5 ERT, which is used in the treatment of various solid tumors such as non small-cell lung cancer, is available in oral form.…”

Long Non-Coding RNA CAR10 Facilitates Non-Small Cell Lung Cancer Cell Migration and Invasion by Modulating the miR-892a/GJB2 Pathway

“… 3 At initial diagnosis, a large proportion of patients with NSCLC also exhibit distant metastases at sites, such as the bone, skin, thyroid and the brain. 4 , 5 Therefore, the identification of novel and effective anti-metastatic molecules for the treatment of NSCLC is of great importance. Long non-coding (lnc)RNAs, which are different RNA transcripts without protein coding ability, have been associated with a diverse number of cellular and biological processes.…”