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dc.creatorDafni, U.es
dc.creatorSoo, R. A.es
dc.creatorPeters, S.es
dc.creatorTsourti, Z.es
dc.creatorZygoura, P.es
dc.creatorVervita, K.es
dc.creatorBernabé-Caro, Reyeses
dc.creatorStahel, R. A.es
dc.date.accessioned2023-07-24T07:56:12Z
dc.date.available2023-07-24T07:56:12Z
dc.date.issued2022
dc.identifier.citationDafni, U., Soo, R.A., Peters, S., Tsourti, Z., Zygoura, P., Vervita, K.,...,Stahel, R.A. (2022). Impact of smoking status on the relative efficacy of the EGFR TKI/ angiogenesis inhibitor combination therapy in advanced NSCLCda systematic review and meta-analysis. ESMO open, 7 (3), 100507. https://doi.org/10.1016/j.esmoop.2022.100507.
dc.identifier.issn2059-7029es
dc.identifier.urihttps://hdl.handle.net/11441/148172
dc.description.abstractBackground: The ETOP 10-16 BOOSTER trial failed to demonstrate a progression-free survival (PFS) benefit for adding bevacizumab to osimertinib in second line. An exploratory subgroup analysis, however, suggested a PFS benefit of the combination in patients with a smoking history and prompted us to do this study. Methods: A systematic review and meta-analysis to evaluate the differential effect of smoking status on the benefit of adding an angiogenesis inhibitor to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor therapy was carried out. All relevant randomized controlled trials appearing in main oncology congresses or in PubMed as of 1 November 2021 were used according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Primarily PFS according to smoking status, and secondarily overall survival (OS) were of interest. Pooled and interaction hazard ratios (HRs) were estimated by fixed or random effects models, depending on the detected degree of heterogeneity. Bias was assessed using the revised Cochrane tool for randomized controlled trials (RoB 2). Results: Information by smoking was available for 1291 patients for PFS (seven studies) and 678 patients for OS (four studies). The risk of bias was low for all studies. Combination treatment significantly prolonged PFS for smokers [n ¼ 502, HR ¼ 0.55, 95% confidence interval (CI): 0.44-0.69] but not for nonsmokers (n ¼ 789, HR ¼ 0.92, 95% CI: 0.66-1.27; treatment-by-smoking interaction P ¼ 0.02). Similarly, a significant OS benefit was found for smokers (n ¼ 271, HR ¼ 0.66, 95% CI: 0.47-0.93) but not for nonsmokers (n ¼ 407, HR ¼ 1.07, 95% CI: 0.82-1.42; treatment-by-smoking interaction P ¼ 0.03). Conclusion: In advanced EGFR-non-small-cell lung cancer patients, the addition of an angiogenesis inhibitor to EGFR tyrosine kinase inhibitor therapy provides a statistically significant PFS and OS benefit in smokers, but not in non smokers. The biological basis for this observation should be pursued and could determine whether this might be due to a specific co-mutational pattern produced by tobacco exposure.es
dc.formatapplication/pdfes
dc.format.extent7 p.es
dc.language.isoenges
dc.publisherESMO openes
dc.relation.ispartofESMO open, 7 (3), 100507.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectEGFR mutationses
dc.subjectNSCLCes
dc.subjectEGFR-TKIes
dc.subjectRandomised controlled triales
dc.subjectSmoking statuses
dc.titleImpact of smoking status on the relative efficacy of the EGFR TKI/ angiogenesis inhibitor combination therapy in advanced NSCLCda systematic review and meta-analysises
dc.typeinfo:eu-repo/semantics/articlees
dcterms.identifierhttps://ror.org/03yxnpp24
dc.type.versioninfo:eu-repo/semantics/publishedVersiones
dc.rights.accessRightsinfo:eu-repo/semantics/openAccesses
dc.contributor.affiliationUniversidad de Sevilla. Departamento de Medicinaes
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S2059702922001272?via%3Dihubes
dc.identifier.doi10.1016/j.esmoop.2022.100507es
dc.journaltitleESMO openes
dc.publication.volumen7es
dc.publication.issue3es
dc.publication.initialPage100507es

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