Anti-epidermal growth factor receptor monoclonal antibodies in metastatic colorectal cancer: A meta-analysis

摘要

AIM: 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(Mo Abs) in metastatic colorectal cancer(m CRC).METHODS: Randomized controlled trials(RCTs) were identified and the association between KRAS mutation and clinical outcome in m CRC patients treated with anti-EGFR Mo Abs was investigated.Ten RCTs wereincluded 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.Wildtype KRAS m CRC 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 m CRC patients was limited to therapeutic regimens which included anti-EGFR Mo Abs 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 Mo Abs were used as second- or further-line treatment, clinical benefit was still confined to patients with wild-type KRAS.CONCLUSION: KRAS status is a potential predictive marker of clinical benefit due to anti-EGFR Mo Ab therapy in m CRC patients.