Tumor Biology

, Volume 35, Issue 10, pp 10409–10418

Risk/benefit profile of panitumumab-based therapy in patients with metastatic colorectal cancer: evidence from five randomized controlled trials

  • Na-Ping Tang
  • Hua Li
  • Yun-Liang Qiu
  • Guo-Min Zhou
  • Yan Wang
  • Jing Ma
  • Yan Chang
  • Qi-Bing Mei
Research Article

DOI: 10.1007/s13277-014-2354-6

Cite this article as:
Tang, N., Li, H., Qiu, Y. et al. Tumor Biol. (2014) 35: 10409. doi:10.1007/s13277-014-2354-6

Abstract

This study aims to evaluate the risk and benefit profiles of panitumumab-based therapy (PBT) in patients with metastatic colorectal cancer (mCRC). Relevant randomized controlled trials were identified by searching PubMed, Medline, EMBASE and Cochrane Library. Data on progression-free survival (PFS), overall survival (OS), all grade and severe (grade ≥3) adverse events were extracted and pooled to calculate hazard ratios (HRs) and risk ratios (RRs) with 95 % confidence intervals (CIs). Number needed to treat (NNT) for PFS and number needed to harm (NNH) for significantly changed toxicities were calculated. A total of 4,155 patients were included in the analysis. PBT significantly improved PFS (HRrandom = 0.66, 95 % CI = 0.45–0.95) but not OS (HRfixed = 0.93, 95 % CI = 0.83–1.04) when used in the subsequent-line setting. The effect on PFS was more evident in patients with wild-type KRAS (HRrandom = 0.64, 95 % CI = 0.47–0.87) and the NNT for PFS is 11 to 23at 1 year. PBT did not benefit patients when used in the first-line setting. In addition, PBT significantly increased the risk of skin toxicity, infections, diarrhea, dehydration, mucositis, hypokalemia, fatigue, hypomagnesemia, pulmonary embolism and paronychia. The NNHs for skin toxicity, diarrhea, infection, hypokalemia and mucositis are less than 23. In conclusion, when used in the subsequent-line setting, PBT can improve the disease progression, especially in mCRC patients with wild-type KRAS. Regarding the adverse events associated with the PBT, close monitoring and necessary preparations are recommended during the therapy.

Keywords

PanitumumabColorectal cancerMetastaticEfficacyAdverse events

Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  • Na-Ping Tang
    • 1
    • 2
  • Hua Li
    • 2
  • Yun-Liang Qiu
    • 2
  • Guo-Min Zhou
    • 2
  • Yan Wang
    • 2
  • Jing Ma
    • 2
  • Yan Chang
    • 2
  • Qi-Bing Mei
    • 1
    • 3
  1. 1.Department of Pharmacology, School of Life SciencesNorthwestern Polytechnical UniversityXi’anChina
  2. 2.National Shanghai Center for New Drug Safety Evaluation and ResearchShanghaiChina
  3. 3.Department of Pharmacology, School of Pharmacythe Fourth Military Medical UniversityXi’anChina