%0 Journal Article %A MARINA CHIARA GARASSINO %A KAREN BORGONOVO %A ANTONIO ROSSI %A ANDREA MANCUSO %A OLGA MARTELLI %A ANGELO TINAZZI %A SERENA DI COSIMO %A NICLA LA VERDE %A PAOLA SBURLATI %A CELSO BIANCHI %A GABRIELLA FARINA %A VALTER TORRI %T Biological and Clinical Features in Predicting Efficacy of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors: A Systematic Review and Meta-analysis %D 2009 %J Anticancer Research %P 2691-2701 %V 29 %N 7 %X Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), developed for patients with advanced non-small cell lung cancer (NSCLC), give modest results similar to those with chemotherapy. There is evidence of a greater survival benefit from TKIs in patients with certain molecular and clinical features, but results are conflicting. To assess the role of these factors in predicting TKI efficacy, a pooled analysis was performed on data from randomized trials in NSCLC. Materials and Methods: An electronic search of all randomized trials comparing the efficacy or activity of TKIs and a pooled analysis were performed. The hazard ratio (HR) with 95% confidence interval (CI) was calculated for each level of the factors and an interaction test was used to detect differences in treatment effect related to the different levels. Results: Of ten randomized trials identified, five were considered for analysis. Smoking was shown to be the only clinical factor to have a predictive effect (non smokers: overall survival (OS) HR 0.53, 95% CI 0.42-0.67; smokers: HR 0.91, 95% CI 0.81-1.02; p-value for interaction <0.001). A negative predictive value was suggested for K-ras mutations (K-ras+: HR 1.97 95% CI 1.16-3.33; K-ras-: HR 0.79, 95% CI 0.59-1.05; p-value for interaction 0.003). Conclusion: At the present time, none of the biological features which have been evaluated in patients who have undergone therapy using TKIs is proven to be of predictive value; only K-ras mutations and smoking habits can be considered as a possible criteria for selection. Results of prospective randomized trials on biological markers are awaited. %U https://ar.iiarjournals.org/content/anticanres/29/7/2691.full.pdf