Ethnic differences in survival outcome in patients with advanced stage non-small cell lung cancer: Results of a meta-analysis of randomized controlled trials

Ross A. Soo, Marie Loh, Tony S. Mok, Sai Hong I. Ou, Byoung Chul Cho, Wee Lee Yeo, Dan G. Tenen, Richie Soong

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Introduction: Although interethnic differences in survival to cytotoxic chemotherapy in patients with non-small cell lung cancer exist, an analysis of survival outcomes based on ethnicity has not yet been fully evaluated systematically using large patient cohorts. Furthermore, recent trial results may be confounded by the use of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). Methods: A meta-analysis was performed using trials identified through MEDLINE. Summary data on median overall survival (OS), time to progression, progression-free survival, and overall response rate (ORR) were collected from randomized controlled trials. Outcomes were compared between Asian and Caucasian studies. Results: Of the 1182 citations identified, 391 treatment arms (Asian 90 and Caucasian 301) were analyzed. The median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 10.1 and 8.0 months (p < 0.001) and 32.2 and 25.9% (p < 0.001), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination was 9.9 and 6.8 months, 10.4 and 8.6 months, and 9.4 and 8.0 months, respectively (all p < 0.001). In studies published pre-EGFR TKI, the median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 9.1 versus 7.3 months (p < 0.001), respectively, and 29.0 and 23.0% (p < 0.006), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination pre-EGFR TKI was 8.9 and 6.5 months (p < 0.005), 9.1 and 7.5 months (p < 0.001), and 9.3 and 7.6 months (p < 0.003), respectively. In third-generation platinum doublets, the median OS in Asian and Caucasian studies was 11.3 and 9.5 months (p < 0.001), respectively, and ORR was 35.0 and 29.8% (p < 0.001), respectively. Conclusion: Ethnic differences in survival and response rate to chemotherapy exist and should be considered in clinical trial designs especially in the global context.

Original languageEnglish
Pages (from-to)1030-1038
Number of pages9
JournalJournal of Thoracic Oncology
Volume6
Issue number6
DOIs
Publication statusPublished - 2011 Jun

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Non-Small Cell Lung Carcinoma
Meta-Analysis
Randomized Controlled Trials
Survival
Platinum
Epidermal Growth Factor Receptor
Protein-Tyrosine Kinases
Drug Therapy
Survival Analysis
MEDLINE
Pharmaceutical Preparations
Disease-Free Survival
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Soo, Ross A. ; Loh, Marie ; Mok, Tony S. ; Ou, Sai Hong I. ; Cho, Byoung Chul ; Yeo, Wee Lee ; Tenen, Dan G. ; Soong, Richie. / Ethnic differences in survival outcome in patients with advanced stage non-small cell lung cancer : Results of a meta-analysis of randomized controlled trials. In: Journal of Thoracic Oncology. 2011 ; Vol. 6, No. 6. pp. 1030-1038.
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title = "Ethnic differences in survival outcome in patients with advanced stage non-small cell lung cancer: Results of a meta-analysis of randomized controlled trials",
abstract = "Introduction: Although interethnic differences in survival to cytotoxic chemotherapy in patients with non-small cell lung cancer exist, an analysis of survival outcomes based on ethnicity has not yet been fully evaluated systematically using large patient cohorts. Furthermore, recent trial results may be confounded by the use of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). Methods: A meta-analysis was performed using trials identified through MEDLINE. Summary data on median overall survival (OS), time to progression, progression-free survival, and overall response rate (ORR) were collected from randomized controlled trials. Outcomes were compared between Asian and Caucasian studies. Results: Of the 1182 citations identified, 391 treatment arms (Asian 90 and Caucasian 301) were analyzed. The median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 10.1 and 8.0 months (p < 0.001) and 32.2 and 25.9{\%} (p < 0.001), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination was 9.9 and 6.8 months, 10.4 and 8.6 months, and 9.4 and 8.0 months, respectively (all p < 0.001). In studies published pre-EGFR TKI, the median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 9.1 versus 7.3 months (p < 0.001), respectively, and 29.0 and 23.0{\%} (p < 0.006), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination pre-EGFR TKI was 8.9 and 6.5 months (p < 0.005), 9.1 and 7.5 months (p < 0.001), and 9.3 and 7.6 months (p < 0.003), respectively. In third-generation platinum doublets, the median OS in Asian and Caucasian studies was 11.3 and 9.5 months (p < 0.001), respectively, and ORR was 35.0 and 29.8{\%} (p < 0.001), respectively. Conclusion: Ethnic differences in survival and response rate to chemotherapy exist and should be considered in clinical trial designs especially in the global context.",
author = "Soo, {Ross A.} and Marie Loh and Mok, {Tony S.} and Ou, {Sai Hong I.} and Cho, {Byoung Chul} and Yeo, {Wee Lee} and Tenen, {Dan G.} and Richie Soong",
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Ethnic differences in survival outcome in patients with advanced stage non-small cell lung cancer : Results of a meta-analysis of randomized controlled trials. / Soo, Ross A.; Loh, Marie; Mok, Tony S.; Ou, Sai Hong I.; Cho, Byoung Chul; Yeo, Wee Lee; Tenen, Dan G.; Soong, Richie.

In: Journal of Thoracic Oncology, Vol. 6, No. 6, 06.2011, p. 1030-1038.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Ethnic differences in survival outcome in patients with advanced stage non-small cell lung cancer

T2 - Results of a meta-analysis of randomized controlled trials

AU - Soo, Ross A.

AU - Loh, Marie

AU - Mok, Tony S.

AU - Ou, Sai Hong I.

AU - Cho, Byoung Chul

AU - Yeo, Wee Lee

AU - Tenen, Dan G.

AU - Soong, Richie

PY - 2011/6

Y1 - 2011/6

N2 - Introduction: Although interethnic differences in survival to cytotoxic chemotherapy in patients with non-small cell lung cancer exist, an analysis of survival outcomes based on ethnicity has not yet been fully evaluated systematically using large patient cohorts. Furthermore, recent trial results may be confounded by the use of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). Methods: A meta-analysis was performed using trials identified through MEDLINE. Summary data on median overall survival (OS), time to progression, progression-free survival, and overall response rate (ORR) were collected from randomized controlled trials. Outcomes were compared between Asian and Caucasian studies. Results: Of the 1182 citations identified, 391 treatment arms (Asian 90 and Caucasian 301) were analyzed. The median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 10.1 and 8.0 months (p < 0.001) and 32.2 and 25.9% (p < 0.001), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination was 9.9 and 6.8 months, 10.4 and 8.6 months, and 9.4 and 8.0 months, respectively (all p < 0.001). In studies published pre-EGFR TKI, the median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 9.1 versus 7.3 months (p < 0.001), respectively, and 29.0 and 23.0% (p < 0.006), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination pre-EGFR TKI was 8.9 and 6.5 months (p < 0.005), 9.1 and 7.5 months (p < 0.001), and 9.3 and 7.6 months (p < 0.003), respectively. In third-generation platinum doublets, the median OS in Asian and Caucasian studies was 11.3 and 9.5 months (p < 0.001), respectively, and ORR was 35.0 and 29.8% (p < 0.001), respectively. Conclusion: Ethnic differences in survival and response rate to chemotherapy exist and should be considered in clinical trial designs especially in the global context.

AB - Introduction: Although interethnic differences in survival to cytotoxic chemotherapy in patients with non-small cell lung cancer exist, an analysis of survival outcomes based on ethnicity has not yet been fully evaluated systematically using large patient cohorts. Furthermore, recent trial results may be confounded by the use of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). Methods: A meta-analysis was performed using trials identified through MEDLINE. Summary data on median overall survival (OS), time to progression, progression-free survival, and overall response rate (ORR) were collected from randomized controlled trials. Outcomes were compared between Asian and Caucasian studies. Results: Of the 1182 citations identified, 391 treatment arms (Asian 90 and Caucasian 301) were analyzed. The median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 10.1 and 8.0 months (p < 0.001) and 32.2 and 25.9% (p < 0.001), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination was 9.9 and 6.8 months, 10.4 and 8.6 months, and 9.4 and 8.0 months, respectively (all p < 0.001). In studies published pre-EGFR TKI, the median OS and ORR in Asian and Caucasian studies for all chemotherapy regimens was 9.1 versus 7.3 months (p < 0.001), respectively, and 29.0 and 23.0% (p < 0.006), respectively. The median OS in Asian and Caucasian studies for monotherapy, platinum doublets, and three drugs or more combination pre-EGFR TKI was 8.9 and 6.5 months (p < 0.005), 9.1 and 7.5 months (p < 0.001), and 9.3 and 7.6 months (p < 0.003), respectively. In third-generation platinum doublets, the median OS in Asian and Caucasian studies was 11.3 and 9.5 months (p < 0.001), respectively, and ORR was 35.0 and 29.8% (p < 0.001), respectively. Conclusion: Ethnic differences in survival and response rate to chemotherapy exist and should be considered in clinical trial designs especially in the global context.

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