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Cetuximab-based therapy for metastatic colorectal cancer: a meta-analysis of the effect of K-ras mutations

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Cetuximab has a favorable effect on patients with metastatic colorectal cancer harboring wild K-ras gene. This meta-analysis was planned to quantify the benefit.

Methods

A meta-analysis of clinical studies that have used cetuximab-based therapy (CBT) for patients with known K-ras status.

Results

There were four randomized studies (RS) that compared CBT versus non-cetuximab control (NCC) in 2,292 patients, and six non-randomized studies (NRS) included patients received cetuximab after failure of prior chemotherapy (411 patients). Patients in RS with wild K-ras tumor gained more benefit from CBT vs. NCC. For response rate (RR), the odds ratio was 2.10 (p = 0.0002), while the hazard ratio (HR) for progression-free survival (PFS) was 0.64 (p = 0.04). On the other hand, CBT was associated with an adverse effect on RR and no effect on PFS in mutated K-ras. In all patients who received CBT in RS and NRS, those with wild vs. mutated K-ras demonstrated higher RR (odds ratio 3.72; p < 0.0001). Compared with NCC in three RS, CBT showed significant overall survival (OS) advantage in patients with wild K-ras (HR = 0.68; p = 0.01).

Conclusions

The significant clinical benefit of CBT concerning RR, PFS, and OS was restricted to patients with wild-type K-ras. There is a need to better define potential responders to CBT.

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Authors disclosure declaration

None of the authors (EMI, JMZ, and BMB) have any potential conflicts of interest.

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Authors and Affiliations

  1. Department of Oncology, King Faisal Specialist Hospital and Research Center, PO Box 40047, Jeddah, 21499, Kingdom of Saudi Arabia

    Ezzeldin M. Ibrahim & Jamal M. Zekri

  2. Research Center, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia

    Ezzeldin M. Ibrahim & Bakr M. Bin Sadiq

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  1. Ezzeldin M. Ibrahim
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  2. Jamal M. Zekri
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Correspondence to Ezzeldin M. Ibrahim.

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Ibrahim, E.M., Zekri, J.M. & Bin Sadiq, B.M. Cetuximab-based therapy for metastatic colorectal cancer: a meta-analysis of the effect of K-ras mutations. Int J Colorectal Dis 25, 713–721 (2010). https://doi.org/10.1007/s00384-010-0927-4

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