Effect And Safety Of Cetuximab For The Treatment Of Metastatic Colorectal Cancer:a Meta Analysis

Purpose:To assess the efficacy and safety of cetuximab therapy inmetastatic colorectal cancer．Methods:Randomized controlled trials for the treatment of metastaticcolorectal cancer from literature resource as Pubmed, Medline, Embase,Springer, wanfang datebase and the chinese biomedical abstractdatebase.The efficacy including progression free survival(PFS)，medianoverall survival(OS)，overall response rate(ORR)．The safety datacontained adverse events(AEs)，specific grade3-4toxicity data， andsubgroup analysis for the KRAS wild patients.Result:9randomized clinical trials of6268patients were including inthis analysis，3138patients in treatment group with cetuximab and3130one in controlled group.There was a significant PFS benefit in favour ofcetuximab-based therapy (HR=0.81,95%CI:0.71-0.93,P=0.002)and OSbenefit(HR=0.94,95%CI:0.88-1.02,P=0.13),TheORR of cetuximab-basedwas40.8%,and the controlled group was32.4%,significantly higher incetuximab-based treatment (OR=1.56,95%CI:1.39-1.74,P<0.00001). There was a great difference attributed to cetuximab-related Grade3-4skintoxicity(15%VS0.2%,OR=68.43,95%CI:32.43-144.39,P<0.00001).Therewas no obvious difference in Severe Neutropenia(OR=1.14,95%CI:0.99-1.30,P=0.07).In the subgroup analysis,The ORR of cetuximab-basedtherapy increased to60.1%comparing to the controlled group of50.2%(OR=1.4995%CI:1.21-1.85,P=0.002).Wild of KRAS can not increasePFS(HR=0.83,95%CI:0.65-1.06,P=0.14)and OS (HR=1.00,95%CI:0.86-1.16,P=0.97) with cetuximab，compared to the controlled group of samegene type．Conclusion:Cetuximab can improve the ORR and PFS for metastaticcolorectal cancer,but it contributes no benifit to the OS.And it increases therisk of skin toxicity significantly.PFS and OS can not be improved in theKRAS wild type patients treated with cetuximab.