Song Xue, Long Stacey R, Barber Beth, Kassed Cheryl A, Healey Marcus, Jones Clare, Zhao Zhongyun
Thomson Reuters, Cambridge, MA 02140, USA.
Curr Clin Pharmacol. 2012 Feb 1;7(1):56-65. doi: 10.2174/157488412799218806.
The objective of this systematic review is to summarize the literature to date on the rates of infusion reactions (IR) associated with chemotherapies and monoclonal antibody (mAb) drug therapies used for the treatment of metastatic colorectal cancer (mCRC) and the associated clinical and economic impact.
This study searched Medline, Medline (R) In-Process, Embase and Cochrane Library databases for studies on IRs associated with chemotherapy and mAbs in mCRC patients from 2000-2011.
For chemotherapy, the incidence of IRs ranged from 0-71% for all grades and 0-15% for grade 3-4. Rates of all grade IRs associated with cetuximab ranged from 7.6-33% and grade 3-4 IR rates were 0-22%. Rates of all grade IRs associated with panitumumab ranged from 0-4% and rates of grade 3-4 IRs ranged from 0-1%. The overall rate of IRs associated with bevacizumab ranged from 1.6-11%, with a rate of 0-4% for grade 3-4 IRs. A range of 50-100% of patients with grade 3-4 IRs terminated chemotherapy, and 34-100% of cetuximab patients with grade 3-4 IRs discontinued cetuximab therapy. No data were reported for bevacizumab or panitumumab. Only one study evaluated the economic impact of IRs. The study compared cetuximab administrations without an IR to those with an IR requiring resource utilization and found that mean costs were $9308 and $1725 higher for those with an IR requiring an emergency room visit or hospitalization and for those with an IR requiring outpatient treatment, respectively.
The incidence of IRs varies among different mAbs; and IRs may cause treatment disruption and require costly medical interventions.
本系统评价的目的是总结迄今为止关于用于治疗转移性结直肠癌（mCRC）的化疗和单克隆抗体（mAb）药物治疗相关的输注反应（IR）发生率以及相关的临床和经济影响的文献。
本研究在Medline、Medline（R）在研数据库、Embase和Cochrane图书馆数据库中检索2000 - 2011年mCRC患者中与化疗和mAb相关的IR研究。
对于化疗，所有级别的IR发生率为0 - 71%，3 - 4级为0 - 15%。与西妥昔单抗相关的所有级别的IR发生率为7.6 - 33%，3 - 4级IR发生率为0 - 22%。与帕尼单抗相关的所有级别的IR发生率为0 - 4%，3 - 4级IR发生率为0 - 1%。与贝伐单抗相关的IR总体发生率为1.6 - 11%，3 - 4级IR发生率为0 - 4%。50 - 100%的3 - 4级IR患者终止化疗，34 - 100%的3 - 4级IR西妥昔单抗患者停止西妥昔单抗治疗。未报告贝伐单抗或帕尼单抗的数据。仅有一项研究评估了IR的经济影响。该研究比较了无IR的西妥昔单抗给药与需要资源利用的有IR的给药情况，发现对于需要急诊就诊或住院的有IR患者以及需要门诊治疗的有IR患者，平均成本分别高出9308美元和1725美元。
不同mAb的IR发生率各不相同；IR可能导致治疗中断并需要昂贵的医疗干预。
