Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York.
Division of Hematology and Oncology, Stony Brook University Cancer Center, Stony Brook, USA.
Ann Oncol. 2011 Nov;22(11):2366-2374. doi: 10.1093/annonc/mdr016. Epub 2011 Mar 14.
The effect of chemotherapy on the risk of cetuximab-induced acneiform rash is unknown. We carried out a systematic review and meta-analysis of published studies to quantify the incidence and risk of high-grade acneiform rash with combination therapy.
Relevant studies were identified from PubMed database, abstracts presented at the American Society of Clinical Oncology conferences, and Web of Science. Incidence of acneiform rash to cetuximab monotherapy was estimated based on updated data from our previously published meta-analysis. Incidence, relative risk (RR), and 95% confidence intervals (CIs) were calculated based on the heterogeneity of included studies.
A total of 5333 patients from nine trials were included in the analysis. The incidence of high-grade acneiform rash was significantly increased in patients receiving combination treatment (12.8%, 95% CI 9.1% to 17.7%) as compared with cetuximab monotherapy (6.3%, 95% CI 3.7% to 10.5%), with a risk ratio of 2.03 (95% CI 1.52-2.71, P < 0.01). Cetuximab significantly increased the risk of high-grade rash in patients receiving combination therapy (RR = 37.7, 95% CI 17.8-80.0, P < 0.001).
Addition of cytotoxic chemotherapy to cetuximab significantly increases the risk of high-grade acneiform rash compared with cetuximab monotherapy. This emphasizes the need for effective management strategies.
化疗对西妥昔单抗诱导痤疮样皮疹风险的影响尚不清楚。我们进行了一项系统评价和荟萃分析，以量化联合治疗时高等级痤疮样皮疹的发生率和风险。
从 PubMed 数据库、美国临床肿瘤学会会议摘要和 Web of Science 中检索相关研究。根据我们之前发表的荟萃分析的更新数据，估计西妥昔单抗单药治疗的痤疮样皮疹发生率。根据纳入研究的异质性，计算皮疹发生率、相对风险（RR）和 95%置信区间（CI）。
共有来自 9 项试验的 5333 例患者纳入分析。与西妥昔单抗单药治疗相比，联合治疗组（12.8%，95%CI9.1%至 17.7%）患者高等级痤疮样皮疹的发生率显著增加，风险比为 2.03（95%CI1.52 至 2.71，P<0.01）。与西妥昔单抗单药治疗相比，西妥昔单抗联合细胞毒性化疗显著增加了联合治疗患者发生高等级皮疹的风险（RR=37.7，95%CI17.8 至 80.0，P<0.001）。
与西妥昔单抗单药治疗相比，细胞毒性化疗联合西妥昔单抗显著增加了高等级痤疮样皮疹的风险。这强调了需要有效的管理策略。
