Cetuximab-based Therapy is Effective in Chemotherapy-naïve Patients with Advanced and Metastatic Non-small-cell Lung Cancer: A Meta-analysis of Randomized Controlled Trials

Abstract

Randomized controlled trails (RCTs) where cetuximab added to first-line platinum-based chemotherapy for patients with advanced/metastatic non-small-cell lung cancer (NSCLC) have yielded conflicting results. This meta-analysis intended to evaluate the efficacy and safety of cetuximab-based therapy (CBT) in that setting. We analyzed four eligible RCTs that included 1,003 and 1,015 patients randomized to CBT and control intervention, respectively. As compared with the noncetuximab group, CBT demonstrated an 9% reduction in the risk of disease progression [hazard ratio (HR) = 0.91; (CI = 0.83-1.00); p = 0.06], a 13% reduction in the risk of death [HR = 0.87; (CI = 0.78-0.96); p = 0.005], and an approximately 50% increase in objective response rate [odds ratio (OR) = 1.48; (CI = 1.22-1.80); p < 0.0001]. CBT-related adverse events were similar across comparisons except for toxicities known to be associated with anti-EGFR therapy. CBT produced significant clinical benefit with acceptable toxicity as a first-line strategy in patients with advanced/metastatic NSCLC. Further research is needed to identify markers predictive of cetuximab benefit in that disease.

Meta-analysis of Six Randomized Control Trials of Chemotherapy Plus Anti-HER Monoclonal Antibody for Advanced Gastric and Gastroesophageal Cancer

“…Panitumumab is a fully human immunoglobulin G2 monoclonal antibody directed against EGFR, which showed survival benefits in OS and PFS in gastric cancer and advanced colorectal cancer (Douillard et al, 2010a;Waddell et al, 2013). Cetuximab is a chimeric monoclonal antibody that binds to the EGFR and blocks the EGFR signaling cascade, producing significant clinical benefit with acceptable toxicity in patients with advanced/metastatic non-small cell lung cancer (NSCLC) (Mendelsohn et al, 2003;Ibrahim et al, 2011), while results showed no significant benefit of OS (HR 1.00; 95% CI 0.87-1.1; p=0.95) and PFS (HR 1.09;p=0.32)in the intention-to-treat population with advanced gastric cancer (Lordick et al, 2013). Matuzumab is a humanized anti-EGFR monoclonal antibody (anti-EGFR MoAb).…”

Phase II study of pemetrexed and cisplatin plus cetuximab followed by pemetrexed and cetuximab maintenance therapy in patients with advanced nonsquamous non-small cell lung cancer

“…While direct comparisons cannot be made, a recently published meta-analysis examined effectiveness of cetuximab-based therapy in chemotherapy-naive patients with advanced and metastatic NSCLC [30]. As compared to a non-cetuximab control group, cetuximab-based therapy demonstrated a 9% reduction in the risk of disease progression, a 13% reduction in the risk of death, and an approximately 50% increase in ORR.…”

Emerging Therapies for Esophageal Cancer

“…Cetuximab has also shown efficacy in the treatment of non-small-cell lung cancer (NSCLC) [21][22][23][24][25]and locally advanced head and neck squamous cell carcinoma (HNSCC) [26,27].…”