Indirect analysis of first-line therapy for advanced non-small-cell lung cancer with activating mutations in a Japanese population

Future Oncol. 2021 Jan;17(1):103-115. doi: 10.2217/fon-2020-0651. Epub 2020 Sep 22.


Background: Five EGFR-tyrosine kinase inhibitors (EGFR TKIs) are currently available in the first-line setting for non-small-cell lung cancer (NSCLC) in Japan. The aim here was to compare the relative efficacy of EGFR TKIs in the Japanese population. Materials & methods: A systematic review identified randomized controlled trials examining the efficacy of first-line EGFR TKIs. A Bayesian network meta-analysis was used to assess these EGFR TKI comparisons for progression-free survival (PFS). Results: A total of seven randomized controlled trials were identified and considered for network meta-analysis. Dacomitinib showed a trend toward improved PFS versus all comparators. Conclusion: Dacomitinib demonstrated a trend toward improved PFS and therefore, should be considered one of the standard first-line therapies for Japanese patients diagnosed with EGFR+ non-small-cell lung cancer.

Keywords: EGFR positive; Japanese population; network meta-analysis; non-small-cell lung cancer; progression-free survival; tyrosine kinase inhibitors.

Publication types

  • Comparative Study
  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bayes Theorem
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / mortality
  • ErbB Receptors / antagonists & inhibitors
  • ErbB Receptors / genetics
  • Gain of Function Mutation
  • Humans
  • Japan / epidemiology
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / mortality
  • Neoplasm Staging
  • Network Meta-Analysis
  • Progression-Free Survival
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use*
  • Randomized Controlled Trials as Topic


  • Protein Kinase Inhibitors
  • EGFR protein, human
  • ErbB Receptors

Grant support