title: Erlotinib in wild type epidermal growth factor receptor non-small cell lung cancer: A systematic review.
abstract: BACKGROUND
  Targeting epidermal growth factor receptors (EGFR) is an innovative approach to managing non-small cell lung cancer (NSCLC) which harbors EGFR mutation. However, the efficacy of these agents like erlotinib in patients without the mutation is not known.
  
  
  METHODS
  This systematic review included Phase III randomized clinical trials that compared single agent erlotinib to other management options in the setting of NSCLC with reported outcome data on patients with EGFR wild type (EGFRWT) tumors. Outcome data include overall survival (OS), progression free survival (PFS) and response rate (RR). Random effects meta-analysis was used to pool outcomes across studies.
  
  
  RESULTS
  Three studies met the inclusion criteria. These studies included a total of 2044 patients with outcome data on 674 patients with EGFRWT tumors (33%). Meta-analysis revealed a statistically significant improvement in OS with erlotinib (hazard ratio of 0.780; 95% confidence interval: 0.654-0.930, P = 0.006). Data were not available to perform PFS or RR analysis. The quality of this evidence is considered to be moderate to high.
  
  
  CONCLUSIONS
  Our study revealed a significant benefit of erlotinib in patient with EGFRWT tumors compared with other approaches. These findings add another therapeutic option to patients generally considered difficult to treat.
authors.affiliation: Department of Oncology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Abdul-Rahman
authors.initials: AR
authors.lastname: Jazieh
authors.forename: Reem
authors.initials: R
authors.lastname: Al Sudairy
authors.forename: Nada
authors.initials: N
authors.lastname: Abu-Shraie
authors.forename: Wafaa
authors.initials: W
authors.lastname: Al Suwairi
authors.forename: Mazen
authors.initials: M
authors.lastname: Ferwana
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
keywords: Epidermal growth factor; erlotinib; non-small cell lung cancer