Evidence map›Paper›PMID 39358420›Full record

SynthesisScientific reports2024

First-line treatment of EGFR-mutated non-small cell lung cancer with brain metastases: a systematic review and meta-analysis.

Jietao Ma, Xiaoxue Pang, Shuling Zhang, Letian Huang, Li Sun, Chengbo Han

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
  6. 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

6 authors.

Jietao MaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Xiaoxue PangDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Shuling ZhangDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Letian HuangDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Li SunDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Chengbo HanDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China. hanchengbo@sj-hospital.org.

Funding

the Health Promotion for Wellness and Development Project - Special Programme for Oncology Research by the Oasis for Life Public Welfare Service Centre BJHA-CRP-062
6 · The paper itself

Abstract

This systematic review and network meta-analysis evaluates first-line treatment options for patients with EGFR-mutant non-small cell lung cancer (NSCLC) and brain metastases. We analyzed 24 randomized controlled trials (RCTs) involving 2,682 patients, comparing various EGFR tyrosine kinase inhibitors (TKIs) and combination therapies. Direct comparisons showed that the addition of bevacizumab or chemotherapy to first-generation (1G) EGFR-TKIs improved overall survival (OS) compared to 1G TKIs alone, with HRs of 0.704 (95% CI: 0.433-0.973) and 0.682 (95% CI: 0.464-0.899), respectively. However, third-generation (3G) TKI monotherapy did not significantly improve OS compared with 1G TKIs, with an HR of 0.855 (95% CI: 0.511-1.198). Indirect comparisons suggested that the combination of 3G TKIs with chemotherapy provided the most significant improvements in OS and progression-free survival (PFS), significantly outperforming 3G TKIs, with HRs of OS 1.69 (95% CI: 1.14-3.4) and PFS 2.13 (95% CI: 1.28-3.54). Intracranial PFS was best with 1G TKIs plus bevacizumab. Our findings suggest that 3G EGFR-TKIs in combination with chemotherapy may be the most effective strategy for patients with EGFR-mutant NSCLC and brain metastases, though further head-to-head trials are needed for validation.

Indexed as

Brain NeoplasmsCarcinoma, Non-Small-Cell LungErbB ReceptorsLung NeoplasmsMutationProtein Kinase InhibitorsAntineoplastic Combined Chemotherapy ProtocolsBevacizumabHumansProgression-Free SurvivalRandomized Controlled Trials as TopicBevacizumabEGFR protein, humanErbB ReceptorsProtein Kinase InhibitorsBrain metastasesEGFR-TKIsFirst-line therapyNon-small cell lung cancerOverall survival

Identifiers

PMID39358420
PMCPMC11447023

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.