SynthesisThe oncologist2015
The role of smoking status on the progression-free survival of non-small cell lung cancer patients harboring activating epidermal growth factor receptor (EGFR) mutations receiving first-line EGFR tyrosine kinase inhibitor versus platinum doublet chemotherapy: a meta-analysis of prospective randomized trials.
Open access · bronzeAbstract readMeta-Analysis
In one paragraph
Synthesis in The oncologist, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 3 pooled it
6.0field-weighted citation impact, top 3% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- What is the optimal first-line regimen for advanced non-small cell lung cancer patients with epidermal growth factor receptor mutation: a systematic review and network meta-analysis.BMC pulmonary medicine · 2024Pooled it
- First-line treatment of advanced epidermal growth factor receptor (EGFR) mutation positive non-squamous non-small cell lung cancer.The Cochrane database of systematic reviews · 2021Pooled it
- Impact of Sex and Smoking on the Efficacy of EGFR-TKIs in Terms of Overall Survival in Non-small-Cell Lung Cancer: A Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Article
- A Systematic Comparative Analysis of Tumor Size Models Based on Erlotinib Clinical Data in Advanced NSCLC.CPT: pharmacometrics & systems pharmacology · 2025Article
- Effect of EGFR amplification on the prognosis of EGFR-mutated advanced non-small-cell lung cancer patients: a prospective observational study.BMC cancer · 2022Observational
- Prognostic factors for relapse-free survival in stage IB-IIIA primary lung adenocarcinoma by epidermal growth factor receptor mutation status.BMC cancer · 2022Article
- Effect of Smoking on Treatment Efficacy and Toxicity in Patients with Cancer: A Systematic Review and Meta-Analysis.Cancers · 2022Review
- Sex dimorphism in response to targeted therapy and immunotherapy in non-small cell lung cancer patients: a narrative review.Translational lung cancer research · 2022Review
- Pretreatment Neutrophil-to-Lymphocyte Ratio and Smoking History as Prognostic Factors in Advanced Non-Small Cell Lung Cancer Patients Treated with Osimertinib.Tuberculosis and respiratory diseases · 2022Article
- Co-occurrence CDK4/6 amplification serves as biomarkers of de novo EGFR TKI resistance in sensitizing EGFR mutation non-small cell lung cancer.Scientific reports · 2022Article
- ORIENT-31 as the Sakigake "Charging Samurai" Born of IMpower150 but Will MARIPOSA-2 IMPRESS in the "Meiji Modernization" of Post-3G EGFR TKI Progression?Lung Cancer (Auckland, N.Z.) · 2022Article
- Deconstructing ADAURA: It is Time to Forgo Adjuvant Platinum-Based Chemotherapy in Resected IB-IIIALung Cancer (Auckland, N.Z.) · 2022Article
- Association between cigarette smoking and colorectal cancer sidedness: A multi-center big-data platform-based analysis.Journal of translational medicine · 2021Article
- Long term follow-up of EGFR mutated NSCLC cases.Translational oncology · 2021Article
- An observational study to evaluate factors predicting survival in patients of non-small cell lung cancer with poor performance status in resource-constrained settings.Ecancermedicalscience · 2021Article
- Smoking status and pathological response to neoadjuvant chemotherapy among patients with bladder cancer: a pooled analysis.Translational andrology and urology · 2021Article
- Article
- Review
- Chronic nicotine exposure affects programmed death-ligand 1 expression and sensitivity to epidermal growth factor receptor-tyrosine kinase inhibitor in lung cancer.Translational cancer research · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 11 institutions in 3 countries.
Yoshikazu HasegawaIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Masahiko AndoIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA Ignatius.ou@uci.edu mando@med.nagoya-u.ac.jp.
Makoto MaemondoIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Satomi YamamotoIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Shun-Ichi IsaIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Hideo SakaIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Akihito KuboIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Tomoya KawaguchiIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Minoru TakadaIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Rafael RosellIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Takayasu KurataIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA.
Sai-Hong Ignatius OuIzumi Municipal Hospital, Osaka, Japan; Nagoya University Hospital, Nagoya, Aichi, Japan; Miyagi Cancer Center, Miyagi, Japan; University of Kansas Cancer Center, Kansas City, Kansas, USA; National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan; National Hospital Organization Nagoya Medical Center, Aichi, Japan; Aichi Medical University School of Medicine, Nagoya, Aichi, Japan; Graduate School of Medicine, Osaka City University, Osaka, Japan; Koyo Hospital, Wakayama, Japan; Catalan Institute of Oncology, Barcelona, Spain; Kansai Medical University Hirakata Hospital, Osaka, Japan; Chao Family Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, California, USA Ignatius.ou@uci.edu mando@med.nagoya-u.ac.jp.
Aichi Medical University · JPInstitut Català d'Ornitologia · ESIzumi City General Hospital · JPKansai Medical University · JPMiyagi Prefectural Hospital Organization · JPNagoya Medical Center · JPNagoya University Hospital · JPNational Kinki Chuo Hospital for Chest Disease · JPOsaka City University · JPThe University of Kansas Cancer Center · USUniversity of California, Irvine · US
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnivariate analyses from several randomized phase III trials seemed to suggest ever-smokers with advanced mutated epidermal growth factor receptor (EGFRm) non-small cell lung cancer (NSCLC) did not seem to benefit from EGFR tyrosine kinase inhibitors (TKIs) as first-line treatment when compared with platinum-doublet chemotherapy as measured by progression-free survival (PFS).
methodsA literature-based meta-analysis of PFS outcomes as measured by log-transformed pooled hazard ratio (HR) was performed using a random-effect model. Pooled HRs for smoking status, age, gender, ethnicity, type of EGFR mutation, and EGFR TKI were obtained. Comparison of the pooled HR was performed by metaregression analysis.
resultsAmong the 1,649 EGFRm NSCLC patients analyzed from 7 prospective randomized trials (WJTOG3405, NEJ002, EURTAC, OPTIMAL, LUX Lung-3, LUX Lung-6, and ENSURE), 83.7% were Asians, and 30.0% were ever-smokers. An equal percentage of ever-smokers received doublet chemotherapy (30.2%) or EGFR TKI (30.0%). The pooled HR for PFS was 0.29 (95% confidence interval [CI]: 0.21-0.39) for never-smokers and 0.54 (95% CI: 0.38-0.76) for ever-smokers (p < .007 by metaregression). The pooled PFS HR for exon 19 deletion was 0.25 (95% CI: 0.19-0.31) and 0.44 for exon 21 substitution (95% CI: 0.34-0.57) (p < .001 by metaregression analysis). The pooled PFS HR was 0.33 (95% CI: 0.24-0.46) for Asians and 0.48 for non-Asians (95% CI: 0.28-0.84) (p = .261 by metaregression analysis).
conclusionEGFRm NSCLC patients derived significant PFS benefit from TKI over platinum-doublet chemotherapy as first-line treatment regardless of smoking status; however, PFS benefit is significantly better in never-smokers by metaregression analysis.
Indexed as
Antineoplastic AgentsCarboplatinCarcinoma, Non-Small-Cell LungCisplatinDisease ProgressionErbB ReceptorsHumansLung NeoplasmsMutationPrognosisProspective StudiesProtein Kinase InhibitorsRandomized Controlled Trials as TopicSmokingSurvival RateAntineoplastic AgentsCarboplatinCisplatinErbB ReceptorsProtein Kinase InhibitorsAfatinibEGFR mutant non-small cell lung cancerEGFR TKIsErlotinibGefitinibMeta-analysisSmoking status
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