Immune checkpoint inhibitors in EGFR-mutation positive TKI-treated patients with advanced non-small-cell lung cancer network meta-analysis

// Luigi Cavanna 1 , Chiara Citterio 1 and Elena Orlandi 1 1 Oncology and Hematology Department, Oncology Unit, Piacenza General Hospital, Piacenza, Italy Correspondence to: Luigi Cavanna, email: l.cavanna@ausl.pc.it Keywords: immuno-oncology; immunotherapy; NSCLC; EGFR mutation; chemotherapy Received: November 08, 2018 Accepted: December 10, 2018 Published: January 04, 2019 ABSTRACT Non-Small Cell Lung Cancer (NSCLC) patients with Epidermal Growth Factor Receptor (EGFR) mutation benefit from a first line of treatment with tyrosine kinase inhibitors (TKIs). After progression, the choice of treatment is between chemotherapy and immune checkpoint inhibitors, but the role of EGFR mutation in the response to immunotherapy is still unclear. A network meta-analysis was performed and 4 randomized trials comparing immune checkpoint inhibitors versus chemotherapy were identified. A Bayesian network meta-analysis was carried out to compare three checkpoint inhibitors (nivolumab, pembrolizumab and atezolizumab) versus chemotherapy (docetaxel), evaluating their Hazard Ratio (HR) and 95% Confidence Interval (CI) for Overall Survival (OS). Results suggest that patients with NSCLC and EGFR mutation, previously treated with TKIs, show better OS when treated with docetaxel in comparison to checkpoint inhibitors treatment.