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Combined Inhibition of EGFR and VEGF Pathways in Patients with EGFR-Mutated Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

  • Lung Cancer (H Borghaei, Section Editor)
  • Published:
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Abstract

Purpose of Review

Dual inhibition of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) pathways could potentiate improved outcomes in patients with metastatic EGFR-mutated non-small cell lung cancer (NSCLC). The purpose of this systematic review and meta-analysis was to compare the efficacy of an EGFR tyrosine kinase inhibitor (TKI) plus a VEGF inhibitor with EGFR TKI alone for the treatment of EGFR-mutated NSCLC.

Recent Findings

We systematically searched for randomized controlled trials (RCT) that involved patients with EGFR-mutated metastatic NSCLC treated with combination therapy versus EGFR TKI alone. In a pooled analysis of 5 studies, treatment with the combination therapy was associated with statistically significant improvements in progression-free survival (hazard ratio [HR] 0.63, 95% CI [0.54, 0.75]) when compared with control. However, pooled data from 4 studies revealed no statistically significant differences between the 2 groups for overall survival (HR 1.00, 95% CI [0.68, 1.52]) and the objective response rate (relative risk [RR] 1.05, 95% CI [0.97, 1.14]).

Summary

In patients with metastatic EGFR-mutated NSCLC, treatment with EGFR TKI plus VEGF inhibition provided significant improvements in progression-free survival, but not in overall survival or objective response rate, when compared with treatment with EGFR TKI alone.

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Authors and Affiliations

  1. Section of Hematology Oncology, Internal Medicine Department, MedStar Georgetown University Medical Center/Washington Hospital Center, Washington, DC, USA

    Monica Peravali, Chul Kim & Irina Veytsman

  2. Department of Biostatistics and Biomedical Informatics, MedStar Health Research Institute, Hyattsville, MD, USA

    Haijun Wang

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Correspondence to Irina Veytsman.

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Conflict of Interest

Monica Peravali, Haijun Wang, and Irina Veytsman declare no conflict of interest. Chul Kim has received research funding (paid to his institution) from AstraZeneca, Bristol-Myers Squibb, Novartis, Regeneron, Tesaro, Karyopharm, and Debiopharm, and has received compensation from Novartis for service as a consultant.

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Peravali, M., Wang, H., Kim, C. et al. Combined Inhibition of EGFR and VEGF Pathways in Patients with EGFR-Mutated Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis. Curr Oncol Rep 22, 119 (2020). https://doi.org/10.1007/s11912-020-00981-0

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