Abstract
Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations in NSCLC remains uncertain. Therefore, we conducted a meta-analysis to evaluate whether chemotherapy leads to altered EGFR mutation status. Methods: A systematic literature search was performed using the PubMed, OVID, Science Direct, Cochrane Library, and CNKI databases for studies on pre- and post-chemotherapy EGFR mutation status. Relevant studies documenting perichemotherapy EGFR mutation ratios were included. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It was found that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56; p < 0.0001). No significant differences in EGFR mutation alterations were observed in terms of gender, smoking history, EGFR loci, or chemotherapy response in NSCLC patients. Conclusions: Chemotherapy may contribute to altered EGFR status. NSCLC patients with EGFR mutations might need to be considered for EGFR status redeterminations prior to second-line EGFR-TKI treatment or upon tumor recurrence after chemotherapy. Further randomized clinical trials should investigate the impact of neoadjuvant or first-line chemotherapy on EGFR mutation status in NSCLC patients.
Highlights
Emerging evidence indicates that chemotherapy for lung cancer may alter epidermal growth factor receptor (EGFR) mutation status
To identify possible outcomes from unpublished trials containing potentially useful data, we reviewed abstract books and presentations from major recent meetings of the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO), and the World Conference on Lung Cancer
Altered EGFR mutation status plays a crucial role in decision-making for EGFR-TKI therapies and subsequent second-line anti-cancer strategies in modern individualized treatment plans
Summary
Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. Whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations in NSCLC remains uncertain. We conducted a meta-analysis to evaluate whether chemotherapy leads to altered EGFR mutation status. The efficacy of EGFR-TKIs has been shown to be less potent when used as second-line treatment for NSCLC patients refractory to or intolerant of platinum-based combination chemotherapy [4]. The same year, an oncological study by Bai et al reported that chemotherapy may reduce the frequency of EGFR mutations in NSCLC patients [8]. The consideration of altered EGFR mutation status before and after chemotherapy has been tightly linked to the second-line EGFR-TKI treatment of NSCLC, prompting investigations by oncologists into the underlining mechanisms
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
