EGFR-TKI-based vs non-EGFR-TKI-based adjuvant therapy in resected non-small-cell lung cancer with EGFR mutations: a meta-analysis of randomized controlled trials

Figures & data

Table 1 Baseline characteristics of included studies

Reference	Year	Location	Study design	Study period	Stage	Treatment groups	Regimen	Time of EGFR-TKI treatment	Patients	Follow-up	Clinical trial information
Kelly et al^Citation11	2015	International	Multicenter, Phase III	November 2007– July 2010	I–IIIA	A B	Erlotinib Placebo	2 years	102 59	47 months	NCT049543
Li et al^Citation12	2014	China	Phase II	August 2008– September 2011	IIIA–N2	A B	PC + gefitinib PC	6 months	30 30	30.6 months	NA
Goss et al^Citation10	2013	North America	Multicenter, Phase III	September 2002– April 2005	IB–IIIA	A B	Gefitinib Placebo	2 years	7 8	4.7 years	NCT049543
Wu et al^Citation13	2017	China	Multicenter, Phase III	September 2011– April 2014	II–IIIA (N1–N2)	A B	Gefitinib NP	2 years	111 111	36.5 months	NCT1405079
Yue et al^Citation14	2017	China	Multicenter, Phase II	September 2012– May 2015	IIIA	A B	Erlotinib NP	2 years	51 51	33.2 months for erlotinib and 28.1 months for NP	NCT1683175

Notes: Group A, EGFR-TKI-based therapy; Group B, non-EGFR-TKI-based therapy.

Abbreviations: NA, not available; NP, vinorelbine + cisplatin; PC, pemetrexed + carboplatin; TKI, tyrosine kinase inhibitor.

Figure 1 Flow chart for selection of studies.

Abbreviations: ASCO, American Society of Clinical Oncology; WCLC, World Conference on Lung Cancer.

Figure 2 Forest plot of hazard ratio for disease-free survival of resected non-small-cell lung cancer with EGFR mutations.

Abbreviations: chemo, chemotherapy; SE, standard error; TKI, tyrosine kinase inhibitor.

Figure 3 Forest plot of hazard ratio for OS of resected non-small-cell lung cancer with EGFR mutations.

Abbreviations: chemo, chemotherapy; OS, overall survival; SE, standard error; TKI, tyrosine kinase inhibitor.

Table 2 Outcome of toxicity meta-analysis comparing EGFR-TKI-based therapy vs non-EGFR-TKI-based therapy as adjuvant treatment in advanced NSCLC

Toxicity	Number of trials	EGFR-TKI-based therapy			Non-EGFR-TKI-based therapy			Heterogeneity		OR (95% CI)	P-value
		Events	Total	Incidence	Events	Total	Incidence	P-value	I^2
G3-4 rash	4	24	286	8.4%	0	219	0.0%	0.64	0%	10.17 (2.37–43.63)	0.002
G3-4 diarrhea	4	8	286	2.8%	0	219	0.0%	0.96	0%	3.88 (0.82–18.23)	0.09
G3-4 anorexia	3	2	236	0.8%	8	176	4.5%	0.26	25%	0.25 (0.07–0.97)	0.05
G3-4 nausea	3	0	256	0.0%	6	189	3.2%	NA	NA	0.06 (0.00–1.06)	0.05
G3-4 vomiting	3	0	256	0.0%	9	189	4.8%	0.38	0%	0.08 (0.01–0.61)	0.02
G3-4 fever	2	0	136	0.0%	1	117	0.9%	NA	NA	0.27 (0.01–6.73)	0.43
G3-4 anemia	2	0	136	0.0%	5	117	4.3%	NA	NA	0.07 (0.00–1.29)	0.07
G3-4 leukopenia	3	2	186	1.1%	16	160	10.0%	0.05	67%	0.15 (0.01–4.45)	0.35
G3-4 fatigue	2	1	206	0.5%	0	146	0.0%	NA	NA	1.79 (0.07–44.75)	0.72

Abbreviations: TKI, tyrosine kinase inhibitor; G, grade; NSCLC, non-small-cell lung cancer; NA, not available.

Figure 4 Funnel plot of publication bias of hazard ratio for disease-free survival in the meta-analysis.

Abbreviations: chemo, chemotheraphy; SE, standard error; TKI, tyrosine kinase inhibitor.

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