Background: Emerging evidence indicates that chemotherapy for lung cancer may alter
EGFR mutation status. However, whether chemotherapy as a firstline treatment
may increase or reduce the frequency of EGFR mutations in NSCLC remains
uncertain. Therefore, we conducted a meta-analysis to evaluate whether
chemotherapy leads to altered EGFR mutation status. Methods: A
systematic literature search was performed using the PubMed, OVID, Science Direct,
Cochrane Library, and CNKI databases for studies on pre- and post-chemotherapy EGFR mutation status. Relevant
studies documenting perichemotherapy EGFR mutation ratios were
included. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It was
found that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56; p
< 0.0001). No significant differences in EGFR mutation alterations were
observed in terms of gender, smoking history, EGFR loci, or chemotherapy
response in NSCLC patients. Conclusions: Chemotherapy may contribute to
altered EGFR status. NSCLC patients with EGFR mutations might need to be
considered for EGFR status redeterminations prior to second-line EGFR-TKI
treatment or upon tumor recurrence after chemotherapy. Further randomized
clinical trials should investigate the impact of neoadjuvant or first-line
chemotherapy on EGFR mutation status in NSCLC patients.
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