Combination Chemotherapy Regimens Show Promise in Treating Advanced Lung Cancer

Strategic Insights -

A new study published in the Journal of the National Comprehensive Cancer Network has revealed that combination chemotherapy regimens, particularly those involving immunotherapy and anti-angiogenic agents, show significant promise in treating advanced EGFR-mutant non-small cell lung cancer (NSCLC) after failure of EGFR-tyrosine kinase inhibitors (EGFR-TKIs). The study, conducted by researchers at Sun Yat-sen University, analyzed data from 9 randomized controlled trials involving 2,534 patients and found that certain combination regimens significantly prolonged progression-free survival (PFS) and improved objective response rate (ORR) compared to traditional chemotherapy.

Key Takeaways:

  • Combination chemotherapy regimens, including immunotherapy + chemotherapy, bevacizumab + chemotherapy, and anti-angiogenic agents + chemotherapy, show significant promise in treating advanced EGFR-mutant NSCLC after EGFR-TKI failure.
  • The regimens 'Chemo_Ami' (amivantamab + chemotherapy) and 'Chemo_anti-PD-1/PD-L1_anti-VEGF' (anti-angiogenic agents + chemotherapy) significantly prolonged PFS and improved ORR compared to 'Chemo'.
  • 'Chemo_Bev' (bevacizumab + chemotherapy) also significantly reduced the risk of progression compared to 'Chemo'.
  • 'Chemo_IO' (immunotherapy + chemotherapy) failed to improve ORR and provided a modest PFS benefit compared to 'Chemo'.
  • The study highlights the potential benefits of anti-angiogenic agents in creating a therapeutic window for immunotherapy in advanced NSCLC after progression on prior EGFR-TKI treatment.
  • 'Chemo_anti-PD-1/PD-L1_anti-VEGF' and 'Chemo_Ami' are recommended as preferred treatment options for patients who experienced disease progression on EGFR-TKIs.

Statistics:

  • 2,534 patients were involved in the 9 randomized controlled trials analyzed in the study.
  • The regimens 'Chemo_Ami' and 'Chemo_anti-PD-1/PD-L1_anti-VEGF' significantly prolonged PFS with hazard ratios (HR) of 0.48 and 0.51, respectively.
  • The regimens 'Chemo_Ami' and 'Chemo_anti-PD-1/PD-L1_anti-VEGF' also improved ORR with odds ratios (OR) of 3.13 and 2.17, respectively.
  • 'Chemo_Bev' significantly reduced the risk of progression with an HR of 0.66.
  • 'Chemo_IO' failed to improve ORR with an OR of 1.25 and provided a modest PFS benefit with an HR of 0.78.

Sources:

  • Chemotherapy-based Combination Regimens for Advanced Egfr-mutant Nsclc After Egfr-tki Failure: a Network Meta-analysis. Journal of the National Comprehensive Cancer Network, 2025;23(4).
  • NewsRx. Reports on Immunotherapy from Sun Yat-sen University Provide New Insights (Chemotherapy-based Combination Regimens for Advanced Egfr-mutant Nsclc After Egfr-tki Failure: a Network Meta-analysis). Immunotherapy Weekly. May 21, 2025; p 3974.