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Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Therapeutic efficacy comparison of six major EGFR-TKIs in non-small-cell lung cancer patients with an activating EGFR mutation: A network meta-analysis.

Metastatic Non-Small Cell Lung Cancer

Lung Cancer—Non-Small Cell Metastatic

2019 ASCO Annual Meeting

Abstract No:

J Clin Oncol 37, 2019 (suppl; abstr e20671)

Author(s): Fang Wu, Jingyi He, Sixuan Wu, Yan Huang, Yizheng Li, Lishu Zhao, Chunhong Hu; Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China; Department of Oncology, the Second Xiangya Hospital of Central South University, Changsha, China

Abstract Disclosures


Background: EGFR-TKIs are the standard in the first line treatment for patients with advanced NSCLC with EGFR activating mutations.This network meta-analysis was undertaken to compared all the EGFR-TKIs in terms of PFS, overall survival (OS), objective response rate (ORR) and disease control rate (DCR). Methods: The PubMed and Embase databases were screened for relevant studies. We extracted data of ORR, DCR, PFS, and OS from enrolled studies and performed multiple treatment comparisons based on bayesian network meta-analysis. Due to the differences in design of each clinical study, two rounds of analysies were performed. We first compared the therapeutic efficacy of the first-generation TKIs (erlotinib and gefitinib), second-generation TKIs (afatinib or dacomitinib) and third-generation TKIs based on A7471028, ARCHER 1009, LUX-Lung 7, ARCHER 1050 and FLAURA studies. The following comparison between first-generation TKIs (gefitinib, erlotinib and icotinib) and second-generation TKIs was performed based on ICOGEN, A7471028, ARCHER 1009, WJOG 5108L, CTONG 0901, LUX-Lung 7 and ARCHER 1050 studies. Results: Eight trials with 2154 patients and 6 TKIs (gefitinib, erlotinib, icotinib, afatinib, dacomitinib and osimertinib) were included. The first round analysis indicated that Osimertinib ranked best among all the TKIs in terms of DCR, 1y-PFS and 1y-OS. Afatinib ranked first among these similar agents with ORR. The second round analysis showed that second-generation TKIs had potentially better efficacy compared with first-generation TKIs. Icotinib seemed to work best in first-generation TKIs and ranked first among first- and second-generation TKIs in terms of 1y-OS. Conclusions: The third-generation TKIs had better therapeutic efficacy compared with the first-generation TKIs and the second-generation TKIs. However, the second-generation TKIs had better efficacy compared with first-generation TKIs.

Distribution of probabilities of first-, second- and third-generation EGFR-TKIs being ranked in the first place based on network.

First roundOsimertinib0.140.630.710.620.34
Erlotinib or Gefitinib0.
Second roundAfatinib0.610.640.10.300.39

Other Abstracts in this Sub-Category:


1. Association of STK11/LKB1 genomic alterations with lack of benefit from the addition of pembrolizumab to platinum doublet chemotherapy in non-squamous non-small cell lung cancer.

Meeting: 2019 ASCO Annual Meeting Abstract No: 102 First Author: Ferdinandos Skoulidis
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer


2. Real-world outcomes of patients with advanced non-small cell lung cancer (aNSCLC) and autoimmune disease (AD) receiving immune checkpoint inhibitors (ICIs).

Meeting: 2019 ASCO Annual Meeting Abstract No: 110 First Author: Sean Khozin
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer


3. RELAY: A multinational, double-blind, randomized Phase 3 study of erlotinib (ERL) in combination with ramucirumab (RAM) or placebo (PL) in previously untreated patients with epidermal growth factor receptor mutation-positive (EGFRm) metastatic non-small cell lung cancer (NSCLC).

Meeting: 2019 ASCO Annual Meeting Abstract No: 9000 First Author: Kazuhiko Nakagawa
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer