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Concurrent use of anti-VEGF and anti-EGFR antibodies in the treatment of metastatic colorectal cancer: A Meta-analysis of randomized controlled trials
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Abstract:
Objective : To systematically evaluate the efficacy and safety of the concurrent use of anti-VEGF and anti-EGFR antibodies in patients with metastatic colorectal cancer. Methods: PubMed/MEDLINE，Ovid/EMBASE, Cochrane and some other databases together with related meeting abstracts were searched for randomized controlled trials on this topic by two independent researchers. Data were extracted from the included studies and analyzed using Review Manager 5.0.23. Results: A total of 2059 patients in five studies were included in this Meta-analysis. Compared with the control treatment involving an anti-VEGF or anti-EGFR antibody alone, the concurrent use of anti-VEGF and anti-EGFR antibodies decreased the progression-free survival (RR＝1.12, 95% CI: 1.05-1.19) as. Patients in the two treatment groups did not differ significantly in either overall survival (RR＝1.17, 95% CI: 098-1.40) or overall response rate (RR＝097, 95% CI: 0.89-1.07). There were significant differences between the two groups in grade 3/4 adverse cutaneous events (RR＝12.62, 95% CI: 1.90-83.84), grade 3/4 infection (RR＝153, 95% CI: 1.13-2.08), grade 3/4 hypertension (RR＝0.61, 95% CI: 0.42-0.87), and grade 3/4 adverse events of nervous system (RR＝0.54, 95% CI: 037-0.80) but not in grade 3/4 adverse gastrointestinal events (RR＝1.48, 95% CI: 0.79-2.77) and grade 3/4 venous thrombosis (RR＝1.18, 95% CI: 0.84-1.65). Conclusion: The concurrent use of anti-VEGF and anti-EGFR antibodies offer no additional benefits for patients with metastatic colorectal cancer as compared with the use of theses antibodies each alone and therefore should not be recommended in clinics.
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Project supported by the National Natural Science Foundation of China (No. 81273154), and the Foundation of Science and Technology Bureau of Wuxi City (No. CSZ00N1248)
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