Cetuximab-based therapy versus non-cetuximab therapy for advanced cancer: a meta-analysis of 17 randomized controlled trials.

PURPOSE: To assess the efficacy and safety of cetuximab-based therapy versus non-cetuximab therapy for advanced cancer. METHODS: A total of 7,954 patients from 17 randomized controlled trials are identified, with 3,965 patients in the cetuximab group and 3,989 patients in the non-cetuximab group. The outcome was progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and grade 3/4 advent events. RESULTS: There was a significant improvement of PFS (HR 0.83, 95%CI 0.78-0.88), OS (HR 0.89, 0.84-0.95), and ORR in the cetuximab group (OR 1.39, 1.22-1.58). In subgroup analysis, in colorectal cancer, there was a significant improvement of PFS (0.72, 0.66-0.78), OS (0.90, 0.81-1.00), and ORR in the cetuximab group (1.36, 1.15-1.60). In head and neck carcinoma, there was a significant improvement of PFS (0.63, 0.54-0.73), OS (0.78, 0.67-0.91), and ORR in the cetuximab group (1.57, 1.15-2.16). In non-small-cell lung cancer, there was a significant improvement of OS (0.86, 0.76-0.96) in the cetuximab group, and no difference on PFS (0.82, 0.64-1.07) and ORR (1.56, 0.85-2.88). In pancreatic cancer, there was no difference on PFS (1.11, 0.97-1.28), OS (1.07, 0.93-1.25), and ORR (0.94, 0.66-1.33). There were higher incidences of grade 3-4 toxicity (OR 1.84), skin-related toxicity (OR 31.80), acneiform rash (OR 30.14), and hypomagnesemia (OR 6.72) in the cetuximab group. CONCLUSIONS: Cetuximab-based therapy improved PFS and OS, and better ORR versus non-cetuximab therapy. The severe adverse events should be predictable and manageable.