Clinical impact of anti-epidermal growth factor receptor monoclonal antibodies in first-line treatment of metastatic colorectal cancer: meta-analytical estimation and implications for therapeutic strategies

摘要: BACKGROUND: Antiepidermal growth factor receptor (anti-EGFR) monoclonal antibodies (MoAbs) are indicated for the treatment of metastatic colorectal cancer patients, but some scientific issues concerning their efficacy currently unsolved. METHODS: A literature-based meta-analysis was conducted. Hazard ratios (HRs) were extracted from randomized trials progression-free survival (PFS) and overall (OS); event-based risk ratio derived response. Sensitivity analyses to look interactions according KRAS status chemotherapy association regimens performed. RESULTS: Eight (6609 patients) identified. A significant interaction found PFS (wild type vs mutant, P = .001) response rate < .0001). The addition an anti-EGFR MoAb first-line increased in wild-type population (HR, 0.91; 95% confidence interval [CI], 0.84-0.99; .03), had a detrimental effect mutant 1.13; CI, 1.03-1.25; .013). increase probability achieving evident patients (relative risk, 1.17; 1.04-1.33; .011). In this population, adopted favored irinotecan-containing (P .01), at meta-regression analysis relative significantly related .00001) OS .00193) benefit. CONCLUSIONS: The produces clear benefit rate. This advantage is restricted translates into small PFS. At present, irinotecan-based backbone could be preferable option. correlation between activity parameters corroborates hypothesis that MoAbs might more suitable needing tumoral shrinkage. Cancer 2011;. © 2011 American Society.