Summary of findings for the main comparison. Gefitinib compared to chemotherapy for first‐line treatment of advanced NSCLC.
| Gefitinib compared to chemotherapy for first‐line treatment of advanced NSCLC | ||||||
| Patient or population: advanced NSCLC Settings: first‐line treatment Intervention: gefitinib Comparison: chemotherapy | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Chemotherapy | Gefitinib | |||||
| Overall survival (OS) | The mean OS ranged across control groups from 3.5 to 8 months | The mean OS in the intervention group ranged from 2.2 to 5.9 months | HR 0.98 (0.91 to 1.46) | 275 (2 RCTs) | ⊕⊕⊕⊝ MODERATE1 | OS similar in the Asian (HR 0.94, 0.82 to 1.06) and EGFR mutation positive subgroups (HR 0.97, 0.77 to 1.21) |
| Progression‐free survival (PFS) | The PFS ranged across control groups from 2 to 2.9 months | The mean PFS in the intervention group ranged from 1.9 to 2.7 months | HR 1.19 (0.86 to 1.65) | 275 (2 RCTs) | ⊕⊕⊕⊝ MODERATE1 | PFS improved with gefitinib in the Asian subgroup (HR 0.65, 0.43 to 0.98) and the EGFR mutation positive subgroup (HR 0.47, 0.36 to 0.61) |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; EGFR: epidermal growth factor receptor; HR: hazard ratio; NSCLC: non‐small cell lung cancer; OS: overall survival; PFS: progression‐free survival; RCT: randomised controlled trial | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1We downgraded the quality of evidence by one level because of serious indirectness as one study included only elderly patients (> 70 years old).