The Impact of Chemotherapy on EGFR Mutation Status in Non-Small-Cell Lung Cancer: A Meta-Analysis

Background: Emerging evidence indicates that chemotherapy for lung cancer may alterEGFR mutation status. However, whether chemotherapy as a firstline treatmentmay increase or reduce the frequency of EGFR mutations in NSCLC remainsuncertain. Therefore, we conducted a meta-analysis to evaluate whetherchemotherapy leads to altered EGFR mutation status. Methods: Asystematic 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. Relevantstudies documenting perichemotherapy EGFR mutation ratios wereincluded. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It wasfound that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56; pConclusions: Chemotherapy may contribute toaltered EGFR status. NSCLC patients with EGFR mutations might need to beconsidered for EGFR status redeterminations prior to second-line EGFR-TKItreatment or upon tumor recurrence after chemotherapy. Further randomizedclinical trials should investigate the impact of neoadjuvant or first-linechemotherapy on EGFR mutation status in NSCLC patients.