Journal of Cancer Research and Clinical Oncology

, Volume 145, Issue 9, pp 2303–2311 | Cite as

A systematic review of head-to-head trials of approved monoclonal antibodies used in cancer: an overview of the clinical trials agenda

  • Jia Luo
  • Go Nishikawa
  • Vinay PrasadEmail author
Review – Clinical Oncology



Since 1997, several monoclonal antibodies (mAbs) targeting the same receptor or its ligand have been approved for use in oncology. However, no studies have summarized head-to-head trials of these mAbs.


Systematic search of the biomedical literature and for randomized studies comparing mAbs targeting the same receptor or its ligand that have been completed and published, completed and unpublished, or ongoing. We extracted trial characteristics including phase, indication, enrollment or target enrollment, randomization, primary endpoint and sponsor.


Twenty-two approved cancer mAbs had at least one other approved mAb targeting the same receptor or its ligand, totaling 41 different oncology indications. These include 5 anti-CD20 mAbs, 5 anti-PD1/PDL1 mAbs, 4 anti-HER2 mAbs, 3 anti-EGFR mAbs, 3 anti-VEGF mAbs and 2 anti-IL6/IL6R mAbs. Seventeen were completed and published and 14 were unpublished or ongoing trials. The completed and published trials enrolled 11,373 patients and tested 13 mAbs (13/22, 59%). Additionally, 13 (76%) contained drugs manufactured by the same company and 13 (76%) reached conclusions felt to be favorable to the sponsor. Of the 14 ongoing/completed unpublished trials, there is a total target enrollment of 3404 patients with 9 mAbs tested. Of these, 86% (12/14) are testing mAbs manufactured by the same company and 71% (10/14) are sponsored by the company that made the drug being tested.


Most trials test drugs manufactured or sponsored by the same company. An overview of clinical trials agenda may lead to more uniform testing, helping clinicians make better evidence-informed prescribing decisions.


Head-to-head trial Monoclonal antibodies Immunotherapy 


Compliance with ethical standards

Conflict of interest

Dr Prasad reports receiving royalties from his book Ending Medical Reversal; that his work is funded by the Laura and John Arnold Foundation; that he has received honoraria for Grand Rounds/lectures from several universities, medical centers, and professional societies and payments for contributions to Medscape. Drs. Luo and Nishikawa have no conflict of interest.

Supplementary material

432_2019_2984_MOESM1_ESM.docx (192 kb)
Supplementary material 1 (DOCX 191 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of MedicineOregon Health and Science UniversityPortlandUSA
  2. 2.Division of Hematology Oncology, Knight Cancer InstituteOregon Health and Science UniversityPortlandUSA
  3. 3.Department of Public Health and Preventive MedicineOregon Health and Science UniversityPortlandUSA
  4. 4.Senior Scholar in the Center for Health Care EthicsOregon Health and Science UniversityPortlandUSA

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