Cao Hongxin, Cui Lixuan, Ma Wei, Zhu Linhai, Wang Kai, Ni Yang, Wang Yibing, Du Jiajun
Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, 250021, China.
Department of Chemotherapy, Cancer Center, Qilu Hospital of Shandong University, 8, Jinan, Shandong, 250012, People's Republic of China.
Clin Drug Investig. 2017 Feb;37(2):135-153. doi: 10.1007/s40261-016-0475-y.
Cixutumumab is a monoclonal antibody targeting insulin-like growth factor 1 receptor (IGF1R). We sought to evaluate the efficacy of cixutumumab in the treatment of cancer, and to comprehensively assess the associated adverse events in phase II clinical trials.
Data were collected from PubMed, Embase, and Clinicaltrials.gov. The improvement on progression-free survival (PFS) was evaluated by hazard ratio (HR) and 95% confidence intervals (95% CIs). We also carried a meta-analysis to comprehensively evaluate the incidence of adverse events.
The adverse events that were mentioned most frequently were hyperglycemia, anemia, nausea, fatigue, and thrombocytopenia. The most frequent adverse events were hyponatremia (40.28%), fatigue (35.18%), and skin rash (35.11%). Results showed that cixutumumab treatments did not benefit PFS (HR 1.03, 95% CI 0.83-1.26, p = 0.979). The complete response (CR) was rarely seen in phase II trials.
Cixutumumab was well tolerated when used alone and in combination therapies, but its antitumor activity was low in the existing phase II clinical trials. An acceptable incidence of adverse effects supports further investigation of this drug, provided that it shows antitumor activity in combination with other drugs.
西妥昔单抗是一种靶向胰岛素样生长因子1受体(IGF1R)的单克隆抗体。我们试图在II期临床试验中评估西妥昔单抗治疗癌症的疗效,并全面评估相关不良事件。
从PubMed、Embase和Clinicaltrials.gov收集数据。通过风险比(HR)和95%置信区间(95%CI)评估无进展生存期(PFS)的改善情况。我们还进行了一项荟萃分析,以全面评估不良事件的发生率。
最常提及的不良事件为高血糖、贫血、恶心、疲劳和血小板减少。最常见的不良事件为低钠血症(40.28%)、疲劳(35.18%)和皮疹(35.11%)。结果显示,西妥昔单抗治疗对PFS无益处(HR 1.03,95%CI 0.83 - 1.26,p = 0.979)。在II期试验中很少见到完全缓解(CR)。
西妥昔单抗单独使用及联合治疗时耐受性良好,但在现有的II期临床试验中其抗肿瘤活性较低。如果该药物与其他药物联合显示出抗肿瘤活性,那么可接受的不良反应发生率支持对其进行进一步研究。