title: Antiepidermal growth factor receptor monoclonal antibody improves survival outcomes in the treatment of patients with metastatic colorectal cancer.
abstract: The aim of this study was to determine whether or not the addition of anti-epidermal growth factor receptor (anti-EGFR) monoclonal antibody (mAb) to standard chemotherapy or best supportive care (BSC), compared with chemotherapy or BSC alone, can improve overall survival (OS) and progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC), and evaluate the influence of KRAS mutant status on the efficacy of anti-EGFR mAb. Medline, Embase, the Cochrane controlled trials register, and the Science Citation Index were searched. Nine trials were identified, covering a total of 7941 patients. The treatment of mCRC with a combination of anti-EGFR mAb and chemotherapy or BSC, as compared with chemotherapy or BSC alone, improved the OS [hazard ratio (HR), 0.90 (0.84-0.96); P=0.002]. The benefit of anti-EGFR mAb in patients with KRAS wild-type tumors was apparent in relation to a marginal trend toward improved OS [HR, 0.84 (0.70-1.01); P=0.06], and significantly improved PFS [HR, 0.64 (0.51-0.81); P<0.001]. No benefit for the addition of anti-EGFR mAb was detected for any efficacy end-point in patients with KRAS mutant tumors. The summary HRs (anti-EGFR mAb vs control) were 0.98 (0.88-1.08) (P=0.71) for OS and 1.08 (0.94-1.25) (P=0.27) for PFS, respectively. In conclusion, this analysis provides confirmation that, compared with chemotherapy or BSC alone, anti-EGFR mAb with chemotherapy or BSC reduces the risk of progression and death of mCRC and that this benefit is seen only in patients with wild-type KRAS tumors.
authors.affiliation: Department of ENT, Weifang People's Hospital, Weifang Medical University, Weifang, People's Republic of China.
authors.forename: Lida
authors.initials: L
authors.lastname: Wang
authors.forename: Xuemei
authors.initials: X
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Zhixin
authors.initials: Z
authors.lastname: Sheng
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000401:mortality; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D006801:Humans; D009154:Mutation; D009362:Neoplasm Metastasis; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics*
chemical_list: D000911:Antibodies, Monoclonal; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins