PT  - JOURNAL ARTICLE
AU  - Jie-Ying Chen
AU  - Ya-Nan Cheng
AU  - Lei Han
AU  - Feng Wei
AU  - Wen-Wen Yu
AU  - Xin-Wei Zhang
AU  - Shui Cao
AU  - Jin-Pu Yu
TI  - Predictive value of <em>K-ras</em> and <em>PIK3CA</em> in non-small cell lung cancer patients treated with EGFR-TKIs: a systemic review and meta-analysis
AID  - 10.7497/j.issn.2095-3941.2015.0021
DP  - 2015 Jun 01
TA  - Cancer Biology and Medicine
PG  - 126--139
VI  - 12
IP  - 2
4099  - http://www.cancerbiomed.org/content/12/2/126.short
4100  - http://www.cancerbiomed.org/content/12/2/126.full
SO  - Cancer Biol Med2015 Jun 01; 12
AB  - Objective: A meta-analysis was performed to augment the insufficient data on the impact of mutative EGFR downstream phosphatidylinositol-3-kinase (PI3K) and mitogen-activated protein kinase (MAPK) pathways on the clinical efficiency of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment of non-small cell lung cancer (NSCLC) patients.Methods: Network databases were explored in April, 2015. Papers that investigated the clinical outcomes of NSCLC patients treated with EGFR-TKIs according to the status of K-ras and/or PIK3CA gene mutation were included. A quantitative meta-analysis was conducted using standard statistical methods. Odds ratios (ORs) for objective response rate (ORR) and hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS) were calculated.Results: Mutation in K-ras significantly predicted poor ORR [OR =0.22; 95% confidence interval (CI), 0.13-0.35], shorter PFS (HR =1.56; 95% CI, 1.27-1.92), and shorter OS (HR =1.59; 95% CI, 1.33-1.91) in NSCLC patients treated with EGFR-TKIs. Mutant PIK3CA significantly predicted shorter OS (HR =1.83; 95% CI, 1.05-3.20), showed poor ORR (OR =0.70; 95% CI, 0.22-2.18), and shorter PFS (HR =1.79; 95% CI, 0.91-3.53) in NSCLC patients treated with EGFR-TKIs.Conclusion: K-ras mutation adversely affected the clinical response and survival of NSCLC patients treated with EGFR-TKIs. PIK3CA mutation showed similar trends. In addition to EGFR, adding K-ras and PIK3CA as routine gene biomarkers in clinical genetic analysis is valuable to optimize the effectiveness of EGFR-TKI regimens and identify optimal patients who will benefit from EGFR-TKI treatment.