title: Anti-epidermal growth factor receptor monoclonal antibodies in metastatic colorectal cancer: a meta-analysis.
abstract: OBJECTIVE
  To investigate the correlation between Kirsten rat sarcoma viral oncogene homolog (KRAS) status and the therapeutic effects of anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (MoAbs) in metastatic colorectal cancer (mCRC).
  
  
  METHODS
  Randomized controlled trials (RCTs) were identified and the association between KRAS mutation and clinical outcome in mCRC patients treated with anti-EGFR MoAbs was investigated. Ten RCTs were included in this meta-analysis. Progression-free survival and overall survival were used to assess the strength of the relationship between KRAS mutation and clinical outcome.
  
  
  RESULTS
  In first-line treatment, survival benefit was confined to patients with wild-type KRAS. Chemotherapy regimens and angiogenesis inhibitor treatment influenced the results of the analysis. Wild-type KRAS mCRC patients did not seem to benefit from oxaliplatin-based chemotherapy (PFS: HR = 0.88, 95%CI: 0.70-1.10; OS: HR = 0.93, 95%CI: 0.82-1.04). Clinical benefit in mCRC patients was limited to therapeutic regimens which included anti-EGFR MoAbs and fluorouracil-based therapy (PFS: HR = 0.77, 95%CI: 0.69-0.86; OS: HR = 0.85, 95%CI: 0.75-0.95). When anti-EGFR MoAbs were used as second- or further-line treatment, clinical benefit was still confined to patients with wild-type KRAS.
  
  
  CONCLUSIONS
  KRAS status is a potential predictive marker of clinical benefit due to anti-EGFR MoAb therapy in mCRC patients.
authors.affiliation: Qi-Bin Song, Qi Wang, Wei-Guo Hu, Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Qi-Bin
authors.initials: QB
authors.lastname: Song
authors.affiliation: Qi-Bin Song, Qi Wang, Wei-Guo Hu, Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Qi-Bin Song, Qi Wang, Wei-Guo Hu, Department of Oncology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
authors.forename: Wei-Guo
authors.initials: WG
authors.lastname: Hu
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics / Q000276:immunology / Q000401:mortality / Q000473:pathology; D004252:DNA Mutational Analysis; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors* / Q000276:immunology / Q000378:metabolism; D006801:Humans; D058990:Molecular Targeted Therapy; D009154:Mutation; D016017:Odds Ratio; D018579:Patient Selection; D057285:Precision Medicine; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D012307:Risk Factors; D015398:Signal Transduction / Q000187:drug effects; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; C512478:EGFR protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins
keywords: Cetuximab; Colorectal neoplasm; Kirsten rat sarcoma viral oncogene homolog; Meta-analysis; Panitumumab