{
  "abstract": "Background: Comparative evidence regarding the efficacy and safety of almonertinib in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) remains fragmented across randomized and real-world studies. We conducted a systematic review and meta-analysis to comprehensively evaluate the comparative clinical performance of almonertinib.\n\nMethods: Eight electronic databases were systematically searched from inception to March 2025. Comparative studies evaluating almonertinib versus active control regimens in patients with EGFR-mutated NSCLC were included. Random-effects meta-analyses were performed to synthesize objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events. Methodological quality was assessed using the Cochrane Risk of Bias tool and analogous domains for observational studies, and certainty of evidence was evaluated using the GRADE framework.\n\nResults: Fifteen comparative studies involving 1,902 patients met the eligibility criteria. Compared with control regimens, almonertinib was associated with higher pooled ORR (RR = 1.33, 95% CI 1.08–1.65) and DCR (RR = 1.14, 95% CI 1.03–1.26). However, after trim-and-fill adjustment for potential publication bias, the 95% CIs for both ORR and DCR included the null value, suggesting that the observed response benefits may be influenced by small-study effects. No statistically significant differences were observed for pooled PFS or OS. Almonertinib demonstrated a generally favorable safety profile, with a lower incidence of diarrhea, while rates of grade ≥3 adverse events and other major toxicities were broadly comparable between groups. Integrated analyses further suggested consistent concordance between ORR and DCR across most studies, supporting improved short-term disease control despite moderate-to-substantial between-study heterogeneity.\n\nConclusion: Current comparative evidence suggests that almonertinib may improve tumor response and disease control while maintaining a favorable tolerability profile in patients with EGFR-mutated NSCLC. Although favorable objective response outcomes were observed, these benefits may be influenced by small-study effects, and definitive survival advantages remain uncertain. These findings support almonertinib as a clinically meaningful therapeutic option, while underscoring the need for cautious interpretation and for larger, high-quality comparative trials with longer follow-up to further define its long-term clinical value.\n\nSystematic Review Registration: https://doi.org/10.17605/OSF.IO/ZDF2N ; Identifier: OSF.IO/ZDF2N.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Oncology, The First Affiliated Hospital of Xi’an Medical University , ,",
    "Department of Respiratory Medicine, Gansu Provincial Hospital , ,",
    "Department of Respiratory Medicine, Jining First People’s Hospital , ,"
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Biaoxue Rong"
    },
    {
      "affs": [
        1
      ],
      "name": "Hui Pan"
    },
    {
      "affs": [
        2
      ],
      "name": "Tian Fu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanfeng Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Pan Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiaying Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Ying Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b5wnj15t0kdhj.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1932051",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690667/?tool=EBI",
  "id": "b5wnj15t0kdhj",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13690667",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Lung Cancer Treatments and Mutations"
    ]
  ],
  "openalex": "W7221085045",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690667/pdf/?tool=EBI",
  "pmcid": "PMC13690667",
  "pmid": null,
  "published": "2026-10-09",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/b5wnj15t0kdhj.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:59Z",
      "native_id": "PMC:PMC13690667",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13690667"
    },
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1932051",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1932051/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1663-9812",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Comparative effectiveness and safety of almonertinib in EGFR-mutated non-small cell lung cancer: an integrated evidence synthesis",
  "title_text": "Comparative effectiveness and safety of almonertinib in EGFR-mutated non-small cell lung cancer: an integrated evidence synthesis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:06Z",
  "url": "https://research.draconitic.com/paper/b5wnj15t0kdhj",
  "venue": "Frontiers in pharmacology",
  "versions": []
}