Network meta-analyses for EGFR mutation-positive non-small-cell lung cancer: systematic review and overview of methods and shortcomings

Aim: To perform a review of network meta-analyses (NMAs) for the first-line treatment of EGFR mutation-positive non-small-cell lung cancer, and to provide an overview of methodological approaches and potential shortcomings. Materials & methods: We conducted a systematic review of NMAs and evaluated their methodologies, including inclusion/exclusion criteria, information sources, results and outcomes, and statistical methodologies. Results: We identified ten published NMAs using five archetypical network structures. Despite similar objectives, there was substantial variability in the number of trials included in each NMA and in the relative treatment efficacy of the tyrosine kinase inhibitors. Conclusion: We identified methodological issues to explain differences in the findings, criteria for inclusion in NMAs and the degree of lumping of treatments. These factors should be given particular consideration in future research.

Medical researchers often use research methods (called network meta-analysis), using data from clinical trials, to estimate the relative benefits of drug treatments that have not been compared directly. These methods have often been used to compare treatment options for patients with EGFR mutation-positive non-small-cell lung cancer. In this study, we identified and looked at ten published comparisons to see how they were conducted and if the assumptions made by the researchers led to differences in the results. We found that assumptions about the similarity of treatments were an important factor that should be given particular consideration when conducting this type of research in the future.