Erlotinib in wild type epidermal growth factor receptor non-small cell lung cancer: A systematic review

Abdul-Rahman Jazieh; Reem Al Sudairy; Nada Abu-Shraie; Wafaa Al Suwairi; Mazen Ferwana; M Hassan Murad

doi:10.4103/1817-1737.118503

Official publication of the Saudi Thoracic Society, affiliated to King Saud University

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ORIGINAL ARTICLE

Year : 2013 | Volume : 8 | Issue : 4 | Page : 204-208

Erlotinib in wild type epidermal growth factor receptor non-small cell lung cancer: A systematic review

Abdul-Rahman Jazieh¹, Reem Al Sudairy¹, Nada Abu-Shraie², Wafaa Al Suwairi³, Mazen Ferwana⁴, M Hassan Murad⁵
¹ Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
² Department of Oncology, Drug Policy and Economics Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
³ Department of Pediatrics, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
⁴ National and Gulf Center for Evidence Based Medicine, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
⁵ Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA

Correspondence Address:
Abdul-Rahman Jazieh
Department of Oncology, P.O. Box 22490, Riyadh 11426
Saudi Arabia

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/1817-1737.118503

Background: Targeting epidermal growth factor receptors (EGFR) is an innovative approach to managing non-small cell lung cancer (NSCLC) which harbors EGFR mutation. However, the efficacy of these agents like erlotinib in patients without the mutation is not known. Methods: This systematic review included Phase III randomized clinical trials that compared single agent erlotinib to other management options in the setting of NSCLC with reported outcome data on patients with EGFR wild type (EGFRWT) tumors. Outcome data include overall survival (OS), progression free survival (PFS) and response rate (RR). Random effects meta-analysis was used to pool outcomes across studies. Results: Three studies met the inclusion criteria. These studies included a total of 2044 patients with outcome data on 674 patients with EGFRWT tumors (33%). Meta-analysis revealed a statistically significant improvement in OS with erlotinib (hazard ratio of 0.780; 95% confidence interval: 0.654-0.930, P = 0.006). Data were not available to perform PFS or RR analysis. The quality of this evidence is considered to be moderate to high. Conclusion: Our study revealed a significant benefit of erlotinib in patient with EGFRWT tumors compared with other approaches. These findings add another therapeutic option to patients generally considered difficult to treat.

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