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. 2019 Jan 25;19(1):105.
doi: 10.1186/s12885-019-5309-x.

Impact on prognosis of rebiopsy in advanced non-small cell lung cancer patients after epidermal growth factor receptor-tyrosine kinase inhibitor treatment: a systematic review

Takuma Imakita  1 , Hirotaka Matsumoto  2 , Katsuya Hirano  2 , Toshiyuki Morisawa  3 , Azusa Sakurai  2 , Yuki Kataoka  2
Affiliations

Impact on prognosis of rebiopsy in advanced non-small cell lung cancer patients after epidermal growth factor receptor-tyrosine kinase inhibitor treatment: a systematic review

Takuma Imakita et al. BMC Cancer. .

Abstract

Background: Osimertinib, the third-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has become the standard treatment in cases where rebiopsy reveals T790M mutation after the first-line EGFR-TKI treatment. However, the prognosis of patients after rebiopsy, the most important outcome for cancer patients, has not been described sufficiently. This systematic review aimed to clarify whether rebiopsy contributes to improved prognosis in the first- or second-generation EGFR-TKI refractory patients.

Methods: Using free word and control terms related to "non-small cell lung cancer" and "rebiopsy," we searched studies from Medical Literature Analysis and Retrieval System Online via PubMed, Embase, Cochrane Central Register of Controlled Trials, and World Health Organization International Clinical Trials Registry Platform. We included cohort studies and case reports written in English and judged whether each study answers our research questions.

Results: Of the 144 studies included, only one reported the prognosis of patients with/without rebiopsy showing that in EGFR-TKI refractory non-small cell lung cancer patients, the post-progression survival (PPS) was significantly longer in patients who received rebiopsy and treatment based on a resistant mechanism (median PPS 24.2 months) than those who received rebiopsy and salvage regimen (median PPS 15.2 months, p = 0.002) and who did not receive rebiopsy (median PPS 9.7 months, p < 0.001). Most of the other studies reported the detection rate of T790M mutation or rebiopsy procedure.

Conclusions: Only a few previous studies have investigated the effectiveness of rebiopsy. Hence, further study is needed to determine the prognosis or adverse events of rebiopsy.

Keywords: Epidermal growth factor receptor-tyrosine kinase inhibitor; Non-small cell lung cancer; Rebiopsy; T790M mutation.

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Competing interests

The authors declare that they have no competing interest.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
Analytic framework (EGFR, epidermal growth factor; TKI, tyrosine kinase inhibitor; NSCLC, non-small cell lung cancer; OS, overall survival; PFS, progression free survival)
See this image and copyright information in PMC

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