Summary of findings 2. Gefitinib compared to chemotherapy for second‐line treatment of advanced NSCLC.
| Gefitinib compared to chemotherapy for second‐line treatment of advanced NSCLC | ||||||
| Patient or population: advanced NSCLC Settings: second‐line therapy 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 7.1 to 8 months | The mean OS in the intervention group ranged from 7.5 to 7.6 months | HR 1.02 (0.91 to 1.15) | 1607 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | OS similar in Asian patients (HR 0.94, 0.79 to 1.12) and EGFR mutation positive patients (HR 0.83, 0.41 to 1.66). |
| Progression‐free survival (PFS) | The mean PFS ranged across control groups from 2.7 to 3.4 months | The mean PFS in the intervention group ranged from 2.2 to 3 months | HR 1.04 (0.92 to 1.17) | 1607 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | PFS significantly improved in Asian patients (HR 0.71, 0.57 to 0.88) and in patients positive for EGFR mutation (HR 0.24, 0.12 to 0.47) (ranged from 2.7 to 4.1 months versus 4.5 to 7 months). |
| *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 imprecision based on the wide confidence interval.