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Title: Smoking history as a predictive factor of treatment response in advanced non-small-cell lung cancer: a systematic review.
Austin Authors: Mitchell, Paul L R ;Mok, Tony;Barraclough, Helen;Strizek, Alena;Lew, Rebecca;van Kooten, Maximiliano
Affiliation: Department of Medical Oncology, Austin Health, Heidelberg, Melbourne, Vic, Australia
Issue Date: 6-Dec-2011
Publication information: Clinical Lung Cancer 2011; 13(4): 239-51
Abstract: Recent trials in patients with advanced non-small-cell lung cancer (NSCLC) suggest that nonsmokers may benefit more from epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) therapy than will smokers. The aim of this systematic review was to assess smoking history as a predictive factor for treatment outcomes in patients with NSCLC. Relevant published literature was identified through systematic searches of databases (MEDLINE, EMBASE, Cochrane Library), oncology and thoracic journals, and abstracts from major oncology conferences using prespecified criteria. Articles reporting treatment outcomes (overall survival [OS], progression-free survival [PFS], and/or response rate) in smoking history subgroups from randomized controlled trials of targeted therapy and/or chemotherapy were reviewed. Data from 30 trials (32 articles, 4 abstracts) were included. Of these, 23 trials tested first-line therapy. Treatment arms included EGFR TKIs (13 trials), EGFR monoclonal antibodies (2 trials), non-EGFR targeted treatments (9 trials), chemotherapy (27 trials), and placebo or best supportive care only (3 trials). Smoking history definitions and analyses of its effect on treatment outcomes varied widely. Only 11 trials reported testing for a treatment-by-smoking history interaction. The available evidence supports but does not confirm smoking history as a predictive factor for the response to TKIs, particularly in previously treated patients. The evidence does not support smoking history as a predictor of response to non-EGFR-targeted therapies or chemotherapy. Smoking history and its effect on treatment response are inadequately reported. More rigorous collection, analysis, and reporting may clarify whether smoking history is a predictor of treatment response in advanced NSCLC.
Gov't Doc #: 22154074
DOI: 10.1016/j.cllc.2011.08.003
Type: Journal Article
Subjects: Antibodies, Monoclonal.therapeutic use
Antineoplastic Agents.therapeutic use
Carcinoma, Non-Small-Cell Lung.drug therapy
Disease-Free Survival
Lung Neoplasms.drug therapy
Protein-Tyrosine Kinases.antagonists & inhibitors
Receptor, Epidermal Growth Factor.antagonists & inhibitors
Smoking.adverse effects
Survival Rate
Treatment Outcome
Appears in Collections:Journal articles

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