Frontiers in Oncology最新文献

{"title":"Analysis of physical activity levels and influencing factors in cancer survivors after pancreaticoduodenectomy.","authors":"Qiuju Tian, Meiqin Xue, Leying Chen, Min Zhang, Weiyi Zhu, Beiwen Wu","doi":"10.3389/fonc.2024.1428884","DOIUrl":"10.3389/fonc.2024.1428884","url":null,"abstract":"<p><strong>Introduction: </strong>Physical activity is becoming more important in cancer patient care. However, there are limited studies investigating physical activity levels in cancer survivors after pancreaticoduodenectomy. This study aims to assess the present status of physical activity levels in cancer survivors after pancreaticoduodenectomy and whether perioperative metrics and length of follow-up have an impact on physical activity levels in survivorship.</p><p><strong>Methods: </strong>This is a cross-sectional study. The study included cancer survivors who were treated at a tertiary general teaching hospital for pancreaticoduodenectomy from December 2019 to January 2022 following surgery. We quantified physical activity frequency, duration, and intensity using the International Physical Activity Questionnaire-Short Form. Patient demographic and clinical characteristics were obtained via an electronic medical record system. Postoperative complication data were obtained from our survival cohort. Variables univariately associated with the physical activity level at an alpha level of less than 0.1 were included in the logistic regression analysis of factors influencing physical activity in cancer survivors after pancreaticoduodenectomy.</p><p><strong>Results: </strong>A total of 223 patients who met the eligibility criteria completed a telephone survey. The main form of physical exercise is walking, 69.5% of participants' physical activity belongs to the active category, but only 16.6% of participants met the aerobic guideline. Logistic regression showed that cancer survivors without pancreatic fistula were 2.453 times more likely to perform active physical activity in survival than those with pancreatic leakage (<i>p</i> = 0.041). For a one-unit increase in operation duration, there is approximately a 0.5% reduction in the level of active physical activity participation among cancer survivors after pancreaticoduodenectomy (<i>p</i> = 0.015). For each unit increase in follow-up time, post-pancreaticoduodenectomy patients were 1.046 times more likely to participate in active physical activity (<i>p</i> = 0.030).</p><p><strong>Conclusion: </strong>Although half of the cancer survivors after pancreaticoduodenectomy experienced active physical activity, only a small percentage of individuals met the guideline-recommended level of aerobic exercise. More physical activity support should be provided to cancer survivors after pancreaticoduodenectomy. Moreover, operation duration, postoperative pancreatic fistula, and follow-up time should be taken into consideration when giving exercise instructions to postoperative survivors of pancreaticoduodenectomy.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1428884"},"PeriodicalIF":3.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical applications and research progress of totally implantable venous access ports: a literature review.","authors":"Xiao-Min Huang, Xia Li, Jie Deng, Jiong Chen, Liang Qian","doi":"10.3389/fonc.2024.1519728","DOIUrl":"10.3389/fonc.2024.1519728","url":null,"abstract":"<p><p>Totally implantable venous access port (TIVAP), a novel intravenous infusion system that is used for long-term intravenous treatment, has become increasingly popular among cancer patients undergoing chemotherapy and other patients requiring long-term intravenous infusions. This technology has been introduced into clinical practice in China, with successful results. Nevertheless, there are still certain problems; for instance, China has not set up a specialized regulatory agency to oversee research and set guidelines for the comprehensive life-cycle management of TIVAP. Additionally, there exists a disparity in standardized operations and complication management related to TIVAP, which has resulted in variable outcomes, complications, and patient satisfaction with TIVAP implantation across different medical units in China. Therefore, this article aims to provide a systematic overview of the clinical applications and maintenance of TIVAP, both domestically and internationally. Furthermore, this review investigated the latest strategies and associated research on TIVAP implantation and complication management, aiming to provide a basis for standardized surgical and maintenance procedures, protocols to minimize complications, and approaches for enhancing the overall quality of life for patients.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1519728"},"PeriodicalIF":3.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of LDR-brachytherapy for localized prostate cancer.","authors":"Lauri Mäkelä, Anssi Pétas, Arto Mikkola, Harri Visapää","doi":"10.3389/fonc.2024.1326355","DOIUrl":"10.3389/fonc.2024.1326355","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective study aims to evaluate the long-term efficacy and urinary toxicity of LDR-brachytherapy for localized prostate cancer.</p><p><strong>Materials and methods: </strong>235 primary prostate cancer patients treated with LDR-brachytherapy and subsequently followed up in our center were included in this study. Biochemical relapse free survival (bRFS), overall survival (OS), and cancer-specific survival (CSS) were evaluated. Additionally, the incidence of late urinary complications was recorded.</p><p><strong>Results: </strong>Median follow-up time was 11,6 years. 181 patients (77%) were classified as low-risk patients, while 52 patients (22,1%) were intermediate risk. The overall bRFS was 83,8% at 5 years and 72,4% at 10 years. 5- and 10-year OS were 97,8% and 87,8% respectively. There was no statistically significant difference in bRFS or OS between different risk groups. The rate of late urinary complications was 8,9%. Volume of prostate had a statistically significant effect on bRFS, as smaller prostate volumes led to worse bRFS.</p><p><strong>Conclusions: </strong>This retrospective study shows that LDR brachytherapy is an effective treatment for low- and intermediate risk prostate cancer patients with relatively low but still significant risk of late urinary complications.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1326355"},"PeriodicalIF":3.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exosomes in oral squamous cell carcinoma: functions, challenges, and potential applications.","authors":"Bo Zhao, Zuntai Li, Ronghua Li","doi":"10.3389/fonc.2024.1502283","DOIUrl":"10.3389/fonc.2024.1502283","url":null,"abstract":"<p><p>Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of all oral cancers, significantly impacting the survival and quality of life of patients. Exosomes, small extracellular vesicles released by cells, play a crucial role in intercellular communication in cancer. Nevertheless, their function and mechanism in OSCC remain elusive. Search Pubmed, Web of Science, and Cochrane Library using keywords OSCC, exome, diagnosis, and treatment to review the research progress of exome in OSCC. Based on these results, this review starting from the biosynthesis, structure, and contents of exosomes, elaborates on the research progress of exosomes in the diagnosis and treatment of OSCC. It explores the potential of exosomes in the diagnosis and treatment of OSCC, and briefly describes the challenges researchers currently face.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1502283"},"PeriodicalIF":3.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implication of fibroblast growth factor 7 in ovarian cancer metastases and patient survival.","authors":"Laura F Mortan, Brooke A Meelheim, Justin Garland, Jacqueline A Bohn, Zitha Redempta Isingizwe, Doris M Benbrook","doi":"10.3389/fonc.2024.1524606","DOIUrl":"10.3389/fonc.2024.1524606","url":null,"abstract":"<p><strong>Background/objectives: </strong>Patients with ovarian cancer commonly experience metastases and recurrences, which contribute to high mortality. Our objective was to better understand ovarian cancer metastasis and identify candidate biomarkers and drug targets for predicting and preventing ovarian cancer recurrence.</p><p><strong>Methods: </strong>Transcripts of 770 cancer-associated genes were compared in cells collected from ascitic fluid versus resected tumors of an ES-2 orthotopic ovarian cancer mouse model. Associated cell types and pathways were explored with bioinformatics. FGF7 protein was measured using capillary-based immunoassays or ELISA in mouse and clinical specimens. Significances of differential gene expression and patient prognosis were determined by volcano plot and log-rank test, respectively.</p><p><strong>Results: </strong>Tumor transcriptomes exhibited higher endothelial cells, oxygenation, proteasome activity, and metabolism in comparison to ascites, but similar percentages of cancer-associated fibroblasts and immune cells. FGF7 mRNA was significantly higher in mouse tumors compared to ascites. FGF7 protein was significantly higher in tumors than in ascites in independent mouse models and clinical specimens. Serum FGF7 protein levels above the median of 25 patients with ovarian cancer were associated with worse progression-free and overall survival (p = 0.005 and 0.019, respectively) independent of patient and tumor characteristics.</p><p><strong>Conclusions: </strong>In comparison to ascites, tumors exhibit different transcriptomic profiles that identify candidate biomarkers and drug targets for predicting and preventing recurrence. Among these, elevated tumoral FGF7 validated at the protein level and elevated serum FGF7 were significantly associated with worse patient survival. These results support further development of FGF7 receptor-targeted drugs and serum FGF7 to prevent and predict recurrence, respectively.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1524606"},"PeriodicalIF":3.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term disease control in dedifferentiated liposarcoma: a case report on trabectedin priming followed by PD-1 inhibition.","authors":"Johannes M Waldschmidt, Lukas Haug, Christine Riedhammer, Christoph K W Deinzer, Marcus Zimmermann, Anke Heidemeier, Peter Raab, Maximilian Rudert, Anne Hendricks, Johan F Lock, Viktoria Buck, Andreas Rosenwald, Hermann Einsele, Peter Reichardt, Volker Kunzmann, Armin Wiegering, Daniel Pink, K Martin Kortüm","doi":"10.3389/fonc.2024.1518775","DOIUrl":"10.3389/fonc.2024.1518775","url":null,"abstract":"<p><strong>Background: </strong>Dedifferentiated liposarcoma (DDLPS) is a rare mesenchymal cancer originating from the adipose tissue, with poor survival rates for most patients, highlighting the critical need for novel treatment options.</p><p><strong>Case description: </strong>This report examines the efficacy and safety of sequential pre-treatment with the marine-derived alkaloid trabectedin followed by checkpoint inhibition using the anti-PD-1 antibody nivolumab in a 63-year-old male patient with unresectable retroperitoneal DDLPS. Treatment was initiated at the time of the seventh relapse as part of the NitraSarc phase 2 multicenter trial for inoperable soft tissue sarcoma conducted by the German Interdisciplinary Sarcoma Group (GISG-15, <i>NCT03590210</i>). The patient demonstrated an immediate tumor response, and in combination with minor surgery, achieved R0 resection status, which was subsequently maintained without the need for further therapy for the past 52 months. Correlative molecular analyses revealed a sustained DNA damage repair machinery and downregulation of PD-1 protein expression in post-treatment tumor samples.</p><p><strong>Conclusion: </strong>This report provides exemplary insight on the feasibility and efficacy of sequential pre-treatment with trabectedin as a priming strategy for PD-1 inhibition in advanced DDLPS. Full trial results from NitraSarc are pending for publication.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1518775"},"PeriodicalIF":3.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pooled safety analysis of two phase 3 studies investigating trifluridine/tipiracil plus bevacizumab in patients with metastatic colorectal cancer.","authors":"Julien Taieb, Marwan Fakih, Gabor Liposits, Gerald W Prager, Eric Van Cutsem, Fortunato Ciardiello, Nadia Amellal, Elizabeth Calleja, Mei Liu, Lucas Roby, Josep Tabernero, Thierry André","doi":"10.3389/fonc.2024.1506075","DOIUrl":"10.3389/fonc.2024.1506075","url":null,"abstract":"<p><strong>Background: </strong>Trifluridine/tipiracil (FTD/TPI) is approved as monotherapy and in combination with bevacizumab for the treatment of patients with refractory metastatic colorectal cancer (mCRC). FTD/TPI plus bevacizumab showed good tolerability in the phase 3 SOLSTICE (first-line) and SUNLIGHT (later-line) trials. This pooled analysis was performed to further characterize the safety of FTD/TPI plus bevacizumab and to compare safety in untreated and previously treated patients with mCRC.</p><p><strong>Methods: </strong>Patients must have received at least one dose of FTD/TPI plus bevacizumab in SOLSTICE (NCT03869892) or SUNLIGHT (NCT04737187). Treatment-emergent adverse events (TEAEs) in SOLSTICE and SUNLIGHT were graded per Common Terminology Criteria for Adverse Events versions 4.03 and 5.0, respectively. Times to onset/resolution of grade ≥3 hematologic TEAEs were assessed using Kaplan-Meier methodology. Treatment-related adverse events (TRAEs) were analyzed by age and Eastern Cooperative Oncology Group performance status (ECOG PS).</p><p><strong>Results: </strong>The pooled safety population comprised 669 patients (SOLSTICE, n = 423; and SUNLIGHT, n = 246). Grade ≥3 TEAEs were reported more frequently in SOLSTICE than in SUNLIGHT (86.8% vs. 72.4%), the most common being neutropenia and anemia. Overall, granulocyte colony-stimulating factor was used in 30.6% of patients. Median time to resolution of grade ≥3 hematologic adverse events/neutropenia to grade ≤2 was 8 days. Grade ≥3 TRAEs were more frequent in patients aged ≥75 years and those with an ECOG PS of 0 versus 1 or 2.</p><p><strong>Conclusions: </strong>FTD/TPI plus bevacizumab showed a consistent and manageable safety profile across first- and later-line mCRC treatment, including in vulnerable patients. Hematologic TEAEs were mostly reversible with appropriate management.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1506075"},"PeriodicalIF":3.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: A rare case of chondrosarcoma-like malignant giant cell tumor in adolescent rib: diagnostic challenges and treatment.","authors":"Zhuolin Qin, Longqian Li, Tao Jing, Cheng Wang","doi":"10.3389/fonc.2024.1523104","DOIUrl":"https://doi.org/10.3389/fonc.2024.1523104","url":null,"abstract":"<p><p>Chondrosarcoma-like malignant giant cell tumor (GCT) of the rib is an extremely rare and aggressive tumor, particularly in adolescents. This case report describes a 19-year-old female presenting with a GCT of the rib with chondrosarcomatous differentiation, highlighting the challenges posed by its unusual location and pathological complexity. Multidisciplinary diagnostic approaches, including advanced imaging, immunohistochemistry (IHC), and pathology, were essential for confirming the diagnosis. Key IHC markers such as Vimentin, SMA, and CD163, alongside genetic analysis excluding H3F3A mutations, guided the diagnostic process. The patient underwent successful surgical resection, achieving early recovery without adjuvant therapy. This report underscores the importance of early detection, precise pathological evaluation, and individualized surgical treatment for rare and high-risk tumors, emphasizing the need for long-term follow-up to monitor recurrence.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1523104"},"PeriodicalIF":3.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeing beyond words: nanotechnology in hepatocellular carcinoma - a bibliometric study.","authors":"Talaiti Tuergan, Aimitaji Abulaiti, Alimu Tulahong, Ruiqing Zhang, Zhongdian Yuan, Yanze Lin, Yingmei Shao, Tuerganaili Aji","doi":"10.3389/fonc.2024.1487198","DOIUrl":"https://doi.org/10.3389/fonc.2024.1487198","url":null,"abstract":"<p><strong>Background: </strong>Nanotechnology has increasingly been applied in the diagnosis and treatment of hepatocellular carcinoma (HCC) over the past two decades. This study aims to explore the utilization of nanotechnology in HCC through a bibliometric analysis, identifying key themes, trends, and contributions in this field.</p><p><strong>Methods: </strong>The study utilized VOSviewer and CiteSpace software to perform a bibliometric analysis, evaluating scholarly contributions related to nanotechnology in HCC. The analysis focused on co-occurrence network relationships, publications, citations, and contributions from various entities and authors.</p><p><strong>Results: </strong>The analysis revealed a total of 2,968 articles, with China and the USA being the most prominent contributors in terms of publications and citations. Notable contributions were made by the Chinese Academy of Sciences and authors Gao Jie and Li Yan. LLOVET JM emerged as the most co-cited author, indicating a leadership role in the field. The \"International Journal of Nanomedicine\" was identified as the leading publisher, while \"Biomaterials\" ranked highest in citations. The research mainly focused on drug delivery systems and apoptosis, highlighting significant advancements in utilizing nanotechnology for HCC treatment.</p><p><strong>Conclusion: </strong>This bibliometric study underscores the critical role of nanotechnology in advancing the diagnosis and treatment of hepatocellular carcinoma, with a particular emphasis on drug delivery and apoptosis. The findings highlight the contributions of key countries, institutions, and authors, reflecting the global effort and collaboration in this rapidly evolving field.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1487198"},"PeriodicalIF":3.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-line treatment for advanced or metastatic EGFR mutation-positive non-squamous non-small cell lung cancer: a network meta-analysis.","authors":"Mengyao Zhang, Lan Sun","doi":"10.3389/fonc.2024.1498518","DOIUrl":"https://doi.org/10.3389/fonc.2024.1498518","url":null,"abstract":"<p><strong>Background: </strong>Several head-to-head meta-analyses have compared the efficacy and safety of different first-line treatments in patients with EGFR mutation-positive (M+) advanced or metastatic non-squamous non-small cell lung cancer (nsq-NSCLC). However, there is a lack of comprehensive evaluation encompassing multiple treatment strategies. Our objective is to conduct a network meta-analysis that includes various treatment modalities, enabling both direct and indirect comparisons for a more thorough assessment.</p><p><strong>Methods: </strong>We conducted a search of PubMed, Embase, Cochrane Library, and Web of Science databases from inception until May 8, 2024, to identify eligible randomized controlled trials (RCTs). The primary endpoints were progression-free survival (PFS) and overall survival (OS), while secondary outcomes included objective response rate (ORR) and grade 3 or higher adverse events (≥3AEs). Stata 15.0 and R 4.3.2 software were utilized for the network meta-analysis.</p><p><strong>Results: </strong>A total of 30 RCTs, comprising 8654 participants, were included. The study encompassed the following 19 treatments: Chemotherapy; Afatinib; Afatinib + Cetuximab; Apatinib + Gefitinib; Befotertinib; Cetuximab + Chemotherapy; Erlotinib; Erlotinib + Bevacizumab; Erlotinib + Chemotherapy; Gefitinib; Gefitinib + Chemotherapy; Gefitinib + Olaparib; Icotinib; Icotinib + Chemotherapy; Lazertinib; Naquotinib; Osimertinib; Osimertinib + Bevacizumab; Osimertinib + Chemotherapy. The network meta-analysis results indicated that, in terms of PFS, Osimertinib + Chemotherapy (SUCRAs: 93.4%) and Osimertinib (SUCRAs: 84.61%) were the most effective. Regarding OS, Lazertinib (SUCRAs: 89.72%), Gefitinib (SUCRAs: 72.07%), and Osimertinib + Chemotherapy (SUCRAs: 70.74%) emerged as the top three options. Afatinib (SUCRAs: 92.27%) was associated with the best ORR improvement. For ≥3AEs, Afatinib (SUCRAs: 74.93%) and Osimertinib (SUCRAs: 69.42%) were likely the best choices.</p><p><strong>Conclusion: </strong>Current evidence suggests that, considering both survival and safety, Osimertinib stands out as the preferred first-line treatment for untreated EGFR M + advanced or metastatic nsq-NSCLC. Notably, the combination of Osimertinib with chemotherapy demonstrated superior survival benefits. However, due to the limitations in the number and quality of included studies, these conclusions await further validation through more high-quality research.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024562981, identifier CRD42024562981.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1498518"},"PeriodicalIF":3.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}