Survival outcomes in EGFR-mutant versus wild-type locally advanced non-small cell lung cancer treated with definitive chemoradiotherapy alone in the pre-PACIFIC/LAURA trial era: A systematic review and meta-analysis using reconstructed individual patient data
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Le résumé fourni par la source
BACKGROUND AND AIMS: This study evaluated the prognostic impact of epidermal growth factor receptor (EGFR) mutations in locally advanced non-small cell lung cancer (NSCLC) treated with definitive chemoradiotherapy (CRT) alone in cohorts in which consolidation durvalumab or osimertinib was not administered as part of the initial post-CRT strategy. METHODS: We systematically reviewed studies comparing CRT outcomes by EGFR status. Individual patient data were reconstructed from published Kaplan-Meier curves using the IPDfromKM method. The proportional hazards assumption was tested, and time-varying effects were modeled when this assumption was violated. The primary endpoints were progression-free survival (PFS) and overall survival (OS). RESULTS: Nine retrospective cohort studies involving 1,239 patients were included. Overall, PFS did not differ by EGFR status (hazard ratio [HR], 1.14; 95% confidence interval [CI], 0.98-1.33). In non-squamous NSCLC, PFS was significantly shorter in EGFR-mutant disease (HR, 1.37; 95% CI, 1.13-1.68). For OS, the proportional hazards assumption was violated. Median OS was 50.8 versus 34.9 months for EGFR-mutant and wild-type disease, respectively. The time-varying model showed a lower early hazard of death in EGFR-mutant disease, with attenuation of this advantage over time. The regression coefficients for EGFR mutation and the EGFR-by-log(time) interaction were -2.37 (standard error [SE], 0.55; p < 0.001) and 0.65 (SE, 0.17; p < 0.001), respectively. CONCLUSION: In CRT-only cohorts from the pre-PACIFIC/LAURA trial era, EGFR-mutant disease showed comparable overall PFS but shorter PFS in non-squamous NSCLC. Although median OS was longer in EGFR-mutant disease, the OS advantage narrowed over time.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Survival outcomes in EGFR-mutant versus wild-type locally advanced non-small cell lung cancer treated with definitive chemoradiotherapy alone in the pre-PACIFIC/LAURA trial era: A systematic review and meta-analysis using reconstructed individual patient data
- Date Crossref
- 01/01/2026
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Ise Red Cross Hospital Department of Radiation Oncology pays non établi dans la noticeÉtablissement de santé
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Mie University Hospital Department of Radiology pays non établi dans la noticeÉtablissement de santé
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Hyogo Medical University pays non établi dans la noticeUniversité ou école supérieure
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Hyogo University pays non établi dans la noticeUniversité ou école supérieure
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Saitama International Medical Center pays non établi dans la noticeÉtablissement de santé
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Mie University Department of Radiology pays non établi dans la noticeUniversité ou école supérieure
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School of Medicine Department of Biostatistics pays non établi dans la noticeUniversité ou école supérieure
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Central Japan International Medical Center Department of Radiation Oncology pays non établi dans la noticeÉtablissement de santé
Department of Radiation Oncology — Ise Red Cross Hospital, Department of Radiology — Mie University Hospital et Hyogo Medical University, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.