Osimertinib for Patients With EGFR-Mutated Non-Small Cell Lung Cancer: Current Evidence.
Background: Osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, has demonstrated efficacy across multiple treatment lines for patients with EGFR-mutated non-small cell lung cancer (NSCLC). However, the optimal treatment sequence and comparative effectiv...
| Publicado en: | Clinical Medicine Insights: Oncology Vol. 20; pp. 1 - 18 |
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| Autores principales: | , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
3/27/2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192584484&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192584484 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795549 B3KT jtl: Clinical Medicine Insights: Oncology issn: 11795549 maglogo: Y pubinfo: dt: 3/27/2026 vid: 20 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 192584484 192584484 192584484 10.1177/11795549261434260 192584484 ppf: 1 ppct: 17 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Osimertinib for Patients With EGFR-Mutated Non-Small Cell Lung Cancer: Current Evidence. aug: au: Tang, Xiumei Chen, Yanmei Zhu, Yuan Liu, Yuan Li, Weimin Wang, Wenzhao Wang, Zhoufeng affil: Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, P.R. China sug: subj: Carcinoma, Non-Small-Cell Lung Drug Therapy Carcinoma, Non-Small-Cell Lung Familial and Genetic Epidermal Growth Factor Receptors Antagonists and Inhibitors Protein Kinase Inhibitors Therapeutic Use Cancer Patients Treatment Outcomes Human Systematic Review Meta Analysis Funding Source Male Female Adult Middle Age Aged Embase Medline PubMed Cochrane Library Checklists Antineoplastic Agents Therapeutic Use Carcinoma, Non-Small-Cell Lung Prognosis Progression-Free Survival Overall Survival Drug Resistance, Neoplasm Descriptive Statistics Odds Ratio Confidence Intervals Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, has demonstrated efficacy across multiple treatment lines for patients with EGFR-mutated non-small cell lung cancer (NSCLC). However, the optimal treatment sequence and comparative effectiveness vs alternative therapies remain unclear. Methods: A systematic review and meta-analysis was conducted following the PRISMA 2020 guidelines. Embase, Medline (via Ovid), PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched from inception to May 31, 2025. Clinical trials comparing osimertinib with other treatments (placebo, EGFR-tyrosine kinase inhibitors [TKIs], chemotherapy, targeted therapy) in patients with EGFR-mutated NSCLC were included. Primary outcomes included objective response rate (ORR), median progression-free survival (mPFS), disease control rate (DCR), overall survival (OS), and adverse events. Subgroup analyses were performed by treatment line and comparator type. Risk of bias was assessed using the Cochrane RoB 2 tool. Statistical analysis was performed using R version 4.5.0 with random-effects models for high heterogeneity (I2> 50%). Results: Sixteen studies encompassing 4931 patients were included. Osimertinib demonstrated significantly superior ORR compared to control treatments (relative risk [RR] = 1.59, 95% confidence interval [CI] = 1.16 to 2.17, P <.001), exceeding the minimal clinically important difference threshold. The mPFS benefit was substantial (standardized mean difference [SMD] = 4.53 months, 95% CI = 1.23 to 7.82, P <.0001), with greater improvements observed in first-line therapy (SMD = 3.25, 95% CI = 0.52 to 5.97) vs second-line treatment (SMD = 7.61, 95% CI = −10.08 to 25.30). The DCR was significantly improved (RR = 1.26, 95% CI = 1.05 to 1.52, P <.0001). The OS showed modest but consistent improvement (SMD = 0.18, 95% CI = 0.11 to 0.26, P <.0001) with no heterogeneity (I2= 0%). Osimertinib was most effective vs chemotherapy and showed consistent benefits vs first-generation TKIs. Adverse events included increased upper respiratory tract infections, skin toxicities, and QT prolongation, while nausea and alopecia were reduced. Conclusions: Osimertinib demonstrates superior efficacy across multiple endpoints in patients with EGFR-mutated NSCLC, with benefits observed in both first-line and second-line settings. The treatment provides clinically meaningful benefits with a manageable safety profile, supporting its use as a preferred therapeutic option across different treatment sequences. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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