Osimertinib is associated with improved outcomes in pre-treated non-small cell lung cancer leptomeningeal metastases: A systematic review and meta-analysiss.

Autor:	Bian DJH; Faculty of Medicine, McGill University, Montreal, Quebec, Canada., Lazaratos AM; Rosalind and Morris Goodman Cancer Institute, Montreal, Quebec, Canada.; Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada., Maritan SM; Faculty of Medicine, McGill University, Montreal, Quebec, Canada.; Rosalind and Morris Goodman Cancer Institute, Montreal, Quebec, Canada.; Department of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada., Quaiattini A; Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada., Zeng Z; Department of Oncology, the Second affiliated hospital of Nanchang University, Nanchang, Jiangxi, China., Zhu Z; Department of Radiation Oncology, Fudan University Shanghai Cancer Center Shanghai, Shanghai, China., Sener U; Department of Neurology, Mayo Clinic, Rochester, MN, USA., Malani R; Department of Neurosurgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Kim YJ; Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea., Ichihara E; Department of Allergy and Respiratory Medicine, Okayama University Hospital, Shikata-cho, Kita-Ku, Okayama City, Okayama, Japan., Cohen V; Faculty of Medicine, McGill University, Montreal, Quebec, Canada.; Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.; Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada., Rose AAN; Faculty of Medicine, McGill University, Montreal, Quebec, Canada.; Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.; Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada., Bouganim N; Faculty of Medicine, McGill University, Montreal, Quebec, Canada.; Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.; McGill University Health Centre, McGill University, Montreal, Quebec, Canada., Dankner M; Faculty of Medicine, McGill University, Montreal, Quebec, Canada.; Rosalind and Morris Goodman Cancer Institute, Montreal, Quebec, Canada.; Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.; McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2024 Apr 17; Vol. 10 (9), pp. e29668. Date of Electronic Publication: 2024 Apr 17 (Print Publication: 2024).
DOI:	10.1016/j.heliyon.2024.e29668
Abstrakt:	Purpose: Leptomeningeal metastasis (LM) is a severe complication of non-small cell lung cancer (NSCLC). In patients with NSCLC LM harboring epidermal growth factor receptor ( EGFR ) mutations, osimertinib is favored over alternative EGFR tyrosine kinase inhibitors (TKIs). However, the efficacy of osimertinib relative to other EGFR-TKIs is not well established for patients with LM. We aimed to compare the efficacy of EGFR-TKIs in EGFR- mutated NSCLC LM. Methods: This systematic review and meta-analysis performed according to PRISMA guidelines included studies of adult patients with EGFR -mutated NSCLC and a diagnosis of LM who received an EGFR-TKI for the treatment of LM. We searched Medline ALL, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science Core Collection. The evaluation of biases was done by using the Ottawa-Newscastle scale. The hazard ratio was used as the parameter of interest for overall survival (OS) and central nervous system-specific progression-free survival (PFS). Results: 128 publications were included with 243 patients and 282 lines of EGFR-TKI for NSCLC LM that met inclusion criteria. The median PFS in patients receiving any EGFR-TKI was 9.1 months, and the median OS was 14.5 months. In univariate analyses of the entire cohort, osimertinib treatment demonstrated significantly prolonged PFS, but not OS, compared to other EGFR-TKIs. Osimertinib demonstrated significantly prolonged PFS and OS in the subset of patients who were previously treated with EGFR-TKIs, but not in EGFR-TKI naïve patients. Conclusion: Osimertinib is associated with improved outcomes compared to other EGFR-TKIs, particularly in patients previously treated with EGFR-TKIs. An important limitation is that most patients were derived from retrospective reports. These results highlight the need for prospective studies for this difficult-to-treat patient population. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:April A. N. Rose conflicts of interest: I = Immediate Family Member Inst = Institutional Research Funding: Canadian Institutes of Health Research (CIHR), Canadian Cancer Society, Conquer Cancer Foundation of ASCO, TransMedTech Institute, Jewish General Hospital Foundation, Canada Foundation for Innovation, Fonds de Recherche du Québec – Santé, Merck (Inst), AstraZeneca (Inst), Seagen (Inst), Pfizer (Inst) Consultant: AstraZeneca Canada, Advanced Accelerator Applications/Novartis, Pfizer (© 2024 The Authors. Published by Elsevier Ltd.)
Databáze:	MEDLINE
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