In a nutshell
This review compared the combination of cetuximab (Erbitux) and chemotherapy to chemotherapy alone in treating advanced non-small cell lung cancer (NSCLC). The review found that combining cetuximab with chemotherapy is more effective than chemotherapy alone. It also found that although there were more adverse effects with the combination treatment, the effects were generally manageable.
Some background
A genetic mutation (change) in the epidermal growth factor receptor (EGFR) has been associated with the development of NSCLC. Cetuximab is a drug that blocks EGFR and can therefore be effective in stopping cancer spreading. Several trials have examined the effectiveness of combining cetuximab with chemotherapy, however results have been inconsistent.
Methods & findings
This review aimed to assess the effectiveness and safety of a combination of cetixumab and chemotherapy.
4 trials, including 2018 patients, were chosen for review. All patients had advanced NSCLC and had not undergone previous EGFR treatment or chemotherapy. 1003 patients were treated cetuximab and chemotherapy (group 1) and 1015 patients were treated with chemotherapy alone (group 2).
Overall survival (OS; time from beginning the trial to death from any cause), progression free survival (PFS; time to disease progression), one year survival rate, objective response rate (ORR; number of patients whose tumors decreased by 50% or disappeared) and serious adverse effects were compared.
The OS was 10.5 months for group 1, compared to 8.9 months in group 2. The PFS was 4.9 months for group 1 and 4.4 months for group 2. The ORR was 30% for group 1 and 23% for group 2. One year survival rate was 45% for group 1 and 40% for group 2.
There were more adverse (negative) effects in group 1 than group 2. These included rash, diarrhea, low potassium and magnesium levels and fevers associated with low levels of white blood cells. There were no cetuximab related deaths.
The bottom line
This study concluded that a combination of cetuximab and chemotherapy was more effective than chemotherapy alone in treating advanced NSCLC. There were more adverse effects with the combination treatment, but these were generally manageable.
The fine print
The studies in this review included mainly Caucasion patients, therefore it is not clear if cetuximab is as effective in patients of all ethnicities. It also remains unknown which chemotherapy drug is most effective in combination with cetuximab.
What’s next?
Speak to your doctor about including cetuximab to your chemotherapy treatment for advanced NSCLC
Published By :
Cochrane database of systematic reviews
Date :
Nov 17, 2014
