Health-related quality of life in non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation with tyrosine kinase inhibitors treatment: a systematic review

Abstract

Tyrosine Kinase Inhibitors (TKIs) have been recommended by the National Comprehensive Cancer Network (NCCN) as first-line therapy in Non-Small Cell Lung Cancer (NSCLC) patients with EGFR mutations. In addition to prolonging Progression-Free Survival and Overall Survival, one of the treatment goals also considers improving the health-related quality of life (HRQOL), which can help to achieve the patients' treatment targets. Several systematic review studies related to HRQOL in advanced NSCLC patients have already been carried out, but there are only a few studies of HRQOL in NSCLC patients who experience EGFR mutations and are treated with TKIs in their specific treatment. This Systematic review aims to provide an overview of the impact of TKIs on HRQOL. Relevant studies were identified from Science Direct, PubMed, and Scopus. They were limited to articles explaining TKIs as first-line therapy, written in English, not a systematic review or meta-analysis, and not containing incomplete text. Electronic data-based search produced 112 articles, with 21 articles matched the title and abstract, yet only nine articles met the inclusion and exclusion to be reviewed. In general, the impact of HRQOL on TKIs is better than platinum and placebo-based chemotherapy. Afatinib, erlotinib, and gefitinib further improved HRQOL compared to platinum and placebo-based chemotherapy seen from the improvements in symptoms, physical function, and social function scale. However, gefitinib vs erlotinib showed no significant difference in patients’ the quality of life. TKIs provide better HRQOL than platinum and placebo-based chemotherapy.