Effectiveness of local ablative therapy combined with first-line tyrosine kinase inhibitors in epidermal growth factor receptor-mutated oligometastatic non-small cell lung cancer: a systematic review and meta-analysis
In brief
Local ablation plus targeted drugs linked to 50% lower death hazard
In a meta-analysis of nine studies and 1,077 patients with EGFR-mutated oligometastatic lung cancer, adding local ablative therapy to a targeted drug was associated with about half the death hazard and a 56% lower hazard of progression or death than drug treatment alone. Toxicity did not differ significantly, but the findings show association, not proof of benefit; which patients benefit most remains unclear.
- Journal
- Clinical & experimental metastasis (Q1)
- Published
- 17 October 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Rahul Bisht, Arusha Desai, Anjali Bhardwaj, Esteban Marcelo Mogrovejo Carrión, Sidharth Misra, Andela Malaj
- PMID
- 42891869
- DOI
- 10.1007/s10585-026-10437-7
Why clinicians should know about it
- Picked for Pulmonary and Respiratory Medicine (paper of the day, 20 October 2026): Meta‑analysis of LAT + EGFR‑TKI vs TKI alone in EGFR‑mut
Abstract
Epidermal Growth Factor Receptor (EGFR) mutations are a significant driver of NSCLC. Although EGFR-Tyrosine Kinase Inhibitors (TKIs) improve outcomes, the development of resistance limits the survival advantages. Local Ablative Therapy (LAT), particularly radiotherapy, may further enhance outcomes in oligometastatic NSCLC, but its benefit remains uncertain. This meta-analysis evaluates the efficacy of LAT with TKI vs. TKI alone. We systematically searched PubMed, Embase, Web of Science, and Cochrane from inception to May 2025 for studies comparing TKI + LAT versus TKI alone, in patients with EGFR-mutated oligometastatic NSCLC. PRISMA guidelines were followed. Outcomes included overall survival (OS), progression-free survival (PFS), and treatment related adverse effects. We pooled hazard ratios (HR) and risk ratios (RR) with a 95% confidence interval (CI) using a random effects model. Statistical Analysis was performed using R software (version 4.4.2). We included 9 studies with 1077 patients, of whom 525 (48.7%) belonged to the TKI + LAT group. Mean follow-up duration was 29.3 months. Patients receiving TKI + LAT had a significantly longer OS (HR 0.50; 95% CI 0.42-0.59; p < 0.001) and PFS (HR 0.44; 95% CI 0.34-0.58; p < 0.001) versus TKI alone. The toxicity risk was not statistically different between the arms, suggesting that LAT did not significantly increase adverse effects. LAT combined with TKI is associated with improved survival in selected patients with EGFR-mutated oligometastatic NSCLC, particularly when delivered as consolidation therapy, with an acceptable safety profile.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.