尽管在表皮生长因子受体（EGFR）突变非小细胞肺癌（NSCLC）中，酪氨酸激酶抑制剂（TKIs）的疗效已经很好地确立，但关于根据患者临床特征比较其有效性的现实世界证据有限。本网络荟萃分析（NMA）比较了不同亚群的东亚NSCLC晚期患者使用一线EGFR-TKIs的生存结果。这项NMA包括了TKIs的实际世界观察研究，报告了年龄大于65岁的患者、基线脑转移、不同东部肿瘤联合组织学群（ECOG）状态或不同常见EGFR突变类型的结果。在EGFR L858R突变患者中，阿法替尼的无进展生存期（PFS）明显长于厄洛替尼（风险比[HR]：0.59，95%可信区间[CI]：0.46-0.75）和吉非替尼（HR：0.41，95% CI：0.32-0.53）。同样，在EGFR Del19突变患者中，阿法替尼和厄洛替尼的PFS明显长于吉非替尼（HR：0.48，95% CI：0.33-0.71和HR：0.54，95% CI：0.36-0.80，分别）。此外，在具有脑转移（HR：0.53，95% CI：0.33-0.87）或ECOG状态0-1的患者中，阿法替尼的PFS明显长于吉非替尼（HR：0.37，95% CI：0.23-0.59）。这项NMA表明，在Del19突变NSCLC、年龄大于等于65岁、ECOG评分为0-1和基线脑转移的患者中，阿法替尼与厄洛替尼的PFS相似，优于吉非替尼。© 2023 作者。中国肺癌临床研究组和John Wiley & Sons Australia有限公司出版的《胸部癌症》发表。

Despite the well-established efficacies of tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC), there is limited real-world evidence comparing their effectiveness according to patients' clinical characteristics. This network meta-analysis (NMA) compared survival outcomes among first-line EGFR-TKIs in different subgroups of East Asian patients with advanced NSCLC.This NMA included real-world observational studies reporting outcomes with TKIs in patients aged >65 years, with baseline brain metastasis, with different Eastern Cooperative Oncology Group (ECOG) statuses, or with different common EGFR mutation types.In patients with the EGFR L858R mutation, afatinib resulted in significantly longer progression-free survival (PFS) than erlotinib (hazard ratio [HR]: 0.59, 95% confidence interval [CI]: 0.46-0.75) and gefitinib (HR: 0.41, 95% CI: 0.32-0.53). Similarly, in patients with the EGFR Del19 mutation, afatinib and erlotinib resulted in significantly longer PFS than gefitinib (HR: 0.48 with 95% CI: 0.33-0.71 and HR: 0.54 with 95% CI: 0.36-0.80, respectively). Moreover, afatinib resulted in significantly longer PFS than gefitinib in patients with brain metastasis (HR: 0.53, 95% CI: 0.33-0.87) or ECOG status 0-1 (HR: 0.37, 95% CI: 0.23-0.59).This NMA suggests that afatinib results in similar PFS to erlotinib and superior PFS than gefitinib in patients with Del19 mutant NSCLC, aged ≥65 years, with ECOG scores of 0-1, and with baseline brain metastasis.© 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.