Dataset Information

Cetuximab or nimotuzumab in combination with chemotherapy for treating recurrent/metastatic nasopharyngeal carcinoma: A meta‑analysis and systemic review.

ABSTRACT: The present study aimed to evaluate the effectiveness and safety of cetuximab (CTX) or nimotuzumab (NTZ) in combination with chemotherapy for patients with recurrent and/or metastatic nasopharyngeal carcinoma (RM-NPC), and for this purpose, a single-group rate meta-analysis was performed. A systematic search of the Cochrane library, Pubmed, EMBASE, Chwina National Knowledge Infrastructure and WanFang databases for studies published until February 15, 2022 was performed. The 1-, 2-, 3- and 5-year overall survival (OS) rates were the primary endpoints. Complete response, partial response, stable disease, objective response rate, disease control rate and grade ≥3 toxicities were considered secondary endpoints. Cochran Q test and I² statistics were performed to assess the heterogeneity among studies. A total of nine studies comprising 435 patients were included in the analysis. The pooled 1-, 2-, 3- and 5-year OS rates were 81.0% [95% confidence interval (CI): 65.0-90.7%], 49.9% (95% CI: 35.3-64.5%), 46.3% (95% CI: 31.4-61.8%) and 31.0% (95% CI: 20.8-43.4%), respectively. The pooled disease control rate and objective response rate were 88.7% (95% CI: 78.4-94.5%) and 55.6% (95% CI: 39.9-70.1%), respectively. In addition, all grade 3-4 adverse events from the included studies were gathered. In conclusion, the use of CTX or NTZ in combination with chemotherapy may be a feasible and safe option for treating RM-NPC.

SUBMITTER: Ni X

PROVIDER: S-EPMC10131271 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Cetuximab or nimotuzumab in combination with chemotherapy for treating recurrent/metastatic nasopharyngeal carcinoma: A meta‑analysis and systemic review.

Ni Xiaoling X Zhang Junqi J Zhu De Du Qing Q Yang Jun J Yue Hong Cheng HC

Oncology letters 20230405 5

The present study aimed to evaluate the effectiveness and safety of cetuximab (CTX) or nimotuzumab (NTZ) in combination with chemotherapy for patients with recurrent and/or metastatic nasopharyngeal carcinoma (RM-NPC), and for this purpose, a single-group rate meta-analysis was performed. A systematic search of the Cochrane library, Pubmed, EMBASE, Chwina National Knowledge Infrastructure and WanFang databases for studies published until February 15, 2022 was performed. The 1-, 2-, 3- and 5-year ...[more]

PMID: 37123019

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Project description:BackgroundThe majority of published studies in recurrent or metastatic nasopharyngeal carcinoma (RM-NPC) are single-arm trials. Reliable modelling of progression-free survival (PFS) and overall survival (OS) outcomes, therefore, is difficult. This study aim to analyse existent literature to estimate the relative efficacy of available systemic regimens in RM-NPC, as well as provide estimates of aggregate OS and PFS.MethodsWe conducted a systematic search of MEDLINE, EMBASE and the Cochrane Library to March 2015. Clinical trials (in English only) investigating cytotoxic and molecularly targeted agents in adult patients with RM-NPC were included. All relevant studies were assessed for quality using Downs and Blacks (DB) checklist (maximum quality score of 27). Aggregate data analysis and Student's t-test were performed for all identified studies (model A). For studies that published analysable Kaplan-Meier curves, survival data were extracted and marginal proportional hazards models were constructed (model B).ResultsA total of 56 studies were identified and included in model A, 26 of which had analysable Kaplan-Meier curves and were included in model B. The 26 studies in model B had significantly higher mean DB scores than the remaining 30 (17.3 vs 13.7, P=0.002). For patients receiving first line chemotherapy, the estimated median OS was 15.7 months by model A (95% CI, 12.3-19.1), and 19.3 months by model B (95% CI, 17.6-21.1). For patients undergoing second line or higher therapies (2nd+), the estimated median OS was 11.5 months by model A (95% CI 10.1-12.9), and 12.5 months by model B (95% CI 11.9-13.4). PFS estimates for patients undergoing first-line chemotherapy by model A was 7.6 months (95% CI, 6.2-9.0), and 8.0 months by model B (95% CI, 7.6-8.8). For patients undergoing therapy in the 2nd+ setting, the estimated PFS by model A was 5.4 months (95% CI, 3.8-7.0), and 5.2 months by model B (95% CI, 4.7-5.6).ConclusionsWe present the first aggregate estimates of OS and PFS for RM-NPC patients receiving first and second-line or higher treatment settings, which could inform the design of future clinical trials in this disease setting.

Project description:To assess the efficacy and safety of the combination of immune checkpoint inhibitors (ICIs) and target therapy (anti-angiogenesis or EGFR inhibitors) as a second-line or subsequent treatment for recurrent or metastatic nasopharyngeal carcinoma (R/M NPC), we conducted a retrospective study. In this study, previously treated R/M NPC patients were administered one of the following treatment: ICIs combined with target therapy and chemotherapy (ITC), ICIs combined with target therapy alone (IT), ICIs combined with chemotherapy (IC), or chemotherapy alone (C). The primary endpoint under consideration was progression-free survival (PFS), while secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety measures. A total of 226 patients participated in this study, with 70 receiving the ITC regimen, 48 receiving IT, 48 treated with IC, and 60 undergoing C alone. The median PFS for the four cohorts was 20.67, 13.63, 12.47, and 7.93 months respectively. Notably, ITC regimen yielded the most favorable PFS among these cohorts. The ITC cohort exhibited a comparable tumor response and safety profile to the IT and IC cohorts (p > 0.05), but superior tumor response compared to the C cohort (p < 0.05). The ITC regimen also conferred a significant improvement in OS when comparing to C alone (HR 0.336, 95%CI 0.123-0.915, p = 0.033). The IT and IC regimens achieved a nearly identical PFS (HR 0.955, 95%CI 0.515-1.77, p = 0.884), although the IT regimen was associated with a lower occurrence of SAEs in contrast to the IC regimen (p < 0.05). In addition, the IT regimen demonstrated superior PFS (HR 0.583, 95%CI 0.345-0.985, p = 0.044) and fewer SAEs when compared to C alone (p < 0.05). These findings collectively support the notion that the combination of ICIs, target and chemotherapy exhibits robust antitumor activity in previously treated R/M NPC patients, without a significant increase in adverse events.

Project description:PurposeCetuximab, an anti-epidermal growth factor receptor monoclonal antibody, carries the potential for combination treatment against nasopharyngeal carcinoma (NPC). We conducted a meta-analysis to assess the possible benefits and safety between the combination treatment with cetuximab and conventional treatment in NPC patients. Skin toxicity (ST) associated with additional cetuximab was evaluated as well.MethodsWe performed a systematic search (PubMed, Embase, Cochrane library, China National Knowledge Infrastructure, and WanFang Data) for studies comparing combination treatment with cetuximab versus conventional treatment in NPC patients. The selected studies included completely or partly reported clinical outcomes including survivals, complete and partial responses, and adverse reactions (ST). The pooled HR, relative risk (RR), and respective 95% CI were estimated by using fixed effects model or random effects model.ResultsA total of 23 relevant studies with available data were included in the final analysis. According to the pooled data, combination treatment with cetuximab showed improved efficacy on increased objective response rate (studies with cetuximab treatment: RR: 1.39, 95% CI: 1.29-1.50; concurrent chemoradiotherapy with or without cetuximab: RR: 1.39, 95% CI: 1.25-1.54) and prolonged survival (studies with cetuximab treatment: the pooled HR for OS was 0.70, 95% CI: 0.55-0.89; concurrent chemoradiotherapy with or without cetuximab: the pooled HR for OS was 0.64, 95% CI: 0.49-0.84) compared with conventional treatment. Moreover, the improved efficacy was invariably accompanied by an increased occurrence of ST (studies with cetuximab treatment: RR: 2.46, 95% CI: 1.81-3.34; concurrent chemoradiotherapy with or without cetuximab: RR: 1.84, 95% CI: 1.02-3.31). However, the majority of adverse reactions exhibited similar occurrence rates between the different treatments.ConclusionPatients with NPC receiving additional cetuximab treatment can benefit more from this systemic comprehensive therapy, while the efficiency of conventional treatment for NPC is limited. ST associated with cetuximab may be used as a potential on-treatment marker to guide treatment with cetuximab against NPC.

Dataset Information

Cetuximab or nimotuzumab in combination with chemotherapy for treating recurrent/metastatic nasopharyngeal carcinoma: A meta‑analysis and systemic review.

Publications

Cetuximab or nimotuzumab in combination with chemotherapy for treating recurrent/metastatic nasopharyngeal carcinoma: A meta‑analysis and systemic review.

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