Evidence map›Paper›PMID 27223081›Full record

SynthesisOncotarget2016

Efficacy of epidermal growth factor receptor inhibitors in combination with chemotherapy in advanced non-small cell lung cancer: a meta-analysis of randomized controlled trials.

Minghui Zhang, Hongsheng Guo, Shu Zhao, Yan Wang, Maopeng Yang, Jiawei Yu, Yubo Yan, Yan Wang

Abstract readMeta-Analysis
In one paragraph

Synthesis in Oncotarget, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Minghui ZhangDepartment of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
Hongsheng GuoDepartment of Medical Oncology, Tianjin Third Central Hospital, Tianjin, 300170, China.
Shu ZhaoDepartment of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
Yan WangDepartment of Medical Oncology, Heilongjiang Provincial Hospital, Harbin, 150000, China.
Maopeng YangDepartment of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
Jiawei YuDepartment of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
Yubo YanDepartment of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.
Yan WangDepartment of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The role of a combination of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and chemotherapy for non-small-cell lung cancer (NSCLC) has not been well established. To clarify this problem, we performed a meta-analysis with 15 studies identified from PubMed, EMBASE and the Cochrane Library. We found that the combined regimen had a significant benefit on progression-free survival (PFS) (hazard ratio (HR) = 0.80; 95% CI = 0.71-0.90; P < 0.001) and the objective response rate (ORR) (RR = 1.35; 95% CI = 1.14-1.59; P < 0.001). However, the combined regimen had no significant impact on overall survival (OS) (HR = 0.96; 95% CI = 0.90-1.03; P = 0.25). Subgroup analysis showed significantly higher OS advantages in EGFR mutation positive patients (P = 0.01), never smokers (P = 0.01), Asian patients (P = 0.02), patients receiving second-line treatment (P < 0.001), and those receiving a sequential combination of EGFR-TKIs and chemotherapy (P = 0.005). The combination regimen showed a higher incidence of grade 3-4 toxicities (leucopenia, neutropenia, febrile neutropenia, anemia, rash, fatigue and diarrhea). In summary, the combination of EGFR-TKIs plus chemotherapy in advanced NSCLC achieved a significantly longer PFS and a higher ORR but not longer OS. Well-designed prospective studies are needed to confirm these findings.

Indexed as

Antineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungDisease-Free SurvivalDrug Delivery SystemsErbB ReceptorsFemaleHumansLung NeoplasmsMaleMutationProportional Hazards ModelsRandomized Controlled Trials as TopicResearch DesignTreatment OutcomeAntineoplastic AgentsErbB Receptorsepidermal growth factor receptornon-small cell lung canceroverall survivaltyrosine kinase inhibitor

Identifiers

PMID27223081
PMCPMC5129973

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.