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Prognostic value of EGFR and KRAS in resected non-small cell lung cancer: a systematic review and meta-analysis

Authors Zhang SM, Zhu QG, Ding XX, Lin S, Zhao J, Guan L, Li T, He B, Zhang HQ

Received 7 March 2018

Accepted for publication 10 May 2018

Published 10 September 2018 Volume 2018:10 Pages 3393—3404

DOI https://doi.org/10.2147/CMAR.S167578

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 4

Editor who approved publication: Dr Leylah Drusbosky


Shi-Ming Zhang, Qing-Ge Zhu, Xiao-Xiao Ding, Song Lin, Jing Zhao, Lei Guan, Ting Li, Bing He, Hu-Qin Zhang

The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi’an JiaoTong University, Xi’an, 710049, China

Background: The prognostic value of EGFR and KRAS mutations in resected non-small cell lung cancer (NSCLC) has been reported. However, conflicting results were reported in these studies. The effect of mutations in these two genes in resected NSCLC remains controversial.
Methods: We searched Internet databases for studies reporting disease-free survival (DFS) and overall survival (OS) in resected NSCLC patients with EGFR or KRAS mutations. A meta-analysis calculating the pooled hazard ratio (HR) for DFS and OS was used to measure the association of EGFR or KRAS mutations with the prognosis of patients after surgery.
Results: A total of 9,635 patients from 32 studies were included in this analysis. The combined HR for EGFR mutations on DFS was 0.77 (95% CI 0.66–0.90, p=0.001) and on OS was 0.72 (95% CI 0.66–0.80, p<0.00001). In addition, the combined HR for KRAS mutations on DFS was 1.5 (95% CI 1.15–1.96, p=0.002) and on OS was 1.49 (95% CI 1.28–1.73, p<0.00001). Sensitivity analysis, subgroup analysis, and bias analysis proved the stability of the results.
Conclusion: The analysis showed that EGFR mutations were significantly associated with DFS and OS. These findings indicated that surgically treated NSCLC patients with EGFR mutations were inclined to exhibit a prolonged DFS and OS. In addition, the results indicated that KRAS mutations predicted worse DFS and OS in patients with resected NSCLC.

Keywords: EGFR mutations, KRAS mutations, meta-analysis, non-small cell lung cancer, prognosis, resected

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