Predictive and Prognostic Biomarkers for Patients Treated with Anti-EGFR Agents in Lung Cancer: A Systemic Review and Meta-Analysis

Background: Several studies have investigated predictive and prognostic biomarkers for patients treated withanti-epidermal growth factor receptor (EGFR) agents in lung cancer. However, the conclusion is controversial.Materials and
Methods: A meta-analysis was conducted to evaluate the associations of mutant K-ras, PIK3CAand PTEN deficiency with the efficacy of anti-EGFR agents in lung cancer. The primary endpoint was objectiveresponse rate (ORR). The secondary endpoints were overall survival (OS) and progression-free survival (PFS).
Results: A total of 61 studies were included in the final meta-analysis. The result showed that K-ras mutationwas a good predictor for ORR (RR=0.42, 95%CI, 0.33-0.55, p=0.000) and an effective prognostic marker for OS(HR=1.37, 95%CI, 1.15-1.65, p=0.001) and PFS (HR=1.33, 95%CI, 1.05-1.69, p=0.019). However, PTEN deficiencyor PIK3CA mutation did not show any significance predictive value for ORR (PTEN, RR=0.82, 95%CI, 0.56-1.19,p=0.286; PIK3CA, RR=1.08, 95%CI, 0.17-6.66, P=0.938). And PTEN deficiency or expression of PIK3CA didnot show significance prognostic value for OS (PTEN, HR=0.88, 95%CI, 0.31-2.46,P=0.805; PIK3CA, HR=0.79,95%CI: 0.23-2.68, P=0.706).
Conclusions: Our meta-analysis showed that K-ras mutation may be an effectivepredictor in lung cancer patients treated with anti-EGFR agents. Whereas, the predictive and prognostic valueof PTEN deficiency and PIK3CA mutation need to be further investigated.