Meta-analysis of chemoimmunotherapy for epidermal growth factor receptor (EGFR) mutation positive non-small cell lung cancer (NSCLC)

Non-small cell lung cancer (NSCLC) is a type of lung cancer that affects a significant number of people worldwide. In particular, advanced stages of this disease can involve specific genetic mutations (change in genes) that impact treatment options. For instance, in 10-15% of advanced NSCLC cases in Western countries, a mutation in the epidermal growth factor receptor (EGFR) gene is present. This rate is even higher in Asia, where more than half of patients with advanced NSCLC have this mutation. EGFR mutations are important because they can make tumors respond well to certain targeted therapies known as EGFR tyrosine kinase inhibitors (TKIs). While these treatments initially work well and improve patients' quality of life, resistance to EGFR TKIs eventually develops in nearly all patients. When this resistance occurs, chemotherapy becomes the standard treatment option.

For patients with advanced NSCLC who do not have the EGFR mutation, a different approach called immunotherapy has shown promise. Immunotherapy involves using drugs to help the immune system recognize and attack cancer cells. Checkpoint inhibitors, a type of immunotherapy, have been effective in extending survival for these patients. However, in my previous research, I found that using immunotherapy alone did not extend survival more than traditional chemotherapy.
Recent studies suggest that combining chemotherapy with immunotherapy, known as "chemoimmunotherapy," might offer better results than chemotherapy alone. This combination approach is currently being tested in trials for patients with EGFR mutations who have progressed after EGFR TKI treatment. While some studies suggest benefits, the results have been mixed, and the effectiveness of this combination may vary among different patient groups.

The goal of this research is to find out how well chemoimmunotherapy works compared to chemotherapy alone for patients with EGFR mutations who have not responded to other treatments. I will look at data from multiple studies to see if this combination treatment offers better results and to determine which specific groups of patients, based on their tumor’s characteristics, benefit the most. This information will help guide future treatment choices and improve patient care.

I will combine results from several clinical trials to get a clearer understanding of how effective chemoimmunotherapy is. By analyzing these results together, I can determine the overall benefits and identify which patients are most likely to benefit. This approach is important for improving treatment strategies and ensuring that patients receive the best possible care based on their individual needs.