Liu Tong, Jiang Shuai, Teng Xue, Zhong Lu, Liu Mengmeng, Jin Yao, Dong Mei
Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China.
Immunopharmacol Immunotoxicol. 2023 Feb;45(1):1-9. doi: 10.1080/08923973.2022.2112222. Epub 2022 Aug 18.
Cetuximab and panitumumab are common antibodies against epidermal growth factor receptor (EGFR) that can be used in combination with chemotherapy for the treatment of metastatic colorectal cancer (mCRC). Although these two drugs are considered to be very similar, differences in the efficacy and safety of cetuximab and panitumumab are still unclear. We conducted this meta-analysis to explore the effects and adverse reactions of cetuximab and panitumumab in the treatment of mCRC.
We searched PubMed, the Cochrane Library, Embase, Web of Science, China national knowledge infrastructure (CNKI) and WanFang databases to identify records related to the efficacy and safety of cetuximab and panitumumab in the treatment of mCRC. The search terms were "cetuximab," "panitumumab," and "colorectal cancer." The deadline of searching was April 2022. Review manager 5.4 software was used to perform the statistical analysis for this meta-analysis. Pooled hazard ratio (HR) with 95% confidence intervals (CI) were calculated to evaluate the overall survival (OS) and progression free survival (PFS) of cetuximab and panitumumab in the treatment of mCRC.
There was no significant difference in OS, PFS, and response rate (RR) between cetuximab arm and panitumumab arm (OS: HR = 0.91, 95% CI = 0.81-1.03, = .14; PFS: HR = 0.92, 95% CI = 0.83-1.02, = .11; RR: OR = 1.22, 95% CI = 0.96-1.61, = .14). We also did not observe any statistical difference between both arms in incidence of acneiform rash, severe acneiform rash, diarrhea, and severe diarrhea (acneiform rash: OR = 1.09, 95% CI = 0.84-1.42, = .51; severe acneiform rash: OR = 1.50, 95% CI = 0.80-2.81, = .21; diarrhea: OR = 1.08, 95% CI = 0.82-1.42, = .58; severe diarrhea: OR = 0.90, 95% CI = 0.44-1.84, = .77). The incidence of paronychia was decreased in the panitumumab arm, but that of hypomagnesemia and severe hypomagnesemia were decreased in the cetuximab arm. (paronychia: OR = 0.74, 95% CI = 0.55-1.00, = .05; hypomagnesemia: OR = 1.85, 95% CI =1.41-2.41, .00001; severe hypomagnesemia: OR = 2.66, 95% CI = 1.52-4.67, .0006).
There was no significant difference in OS, PFS and RR between the cetuximab arm and panitumumab arm in the treatment of mCRC. For adverse reactions, the incidence of paronychia was decreased in the panitumumab arm, and the incidence of hypomagnesemia was deceased in the cetuximab arm.
西妥昔单抗和帕尼单抗是常见的抗表皮生长因子受体（EGFR）抗体，可与化疗联合用于治疗转移性结直肠癌（mCRC）。尽管这两种药物被认为非常相似，但西妥昔单抗和帕尼单抗在疗效和安全性上的差异仍不明确。我们进行了这项荟萃分析，以探讨西妥昔单抗和帕尼单抗在治疗mCRC中的效果和不良反应。
我们检索了PubMed、Cochrane图书馆、Embase、Web of Science、中国国家知识基础设施（CNKI）和万方数据库，以识别与西妥昔单抗和帕尼单抗治疗mCRC的疗效和安全性相关的记录。检索词为“西妥昔单抗”、“帕尼单抗”和“结直肠癌”。检索截止日期为2022年4月。使用Review Manager 5.4软件对该荟萃分析进行统计分析。计算合并风险比（HR）及95%置信区间（CI），以评估西妥昔单抗和帕尼单抗治疗mCRC的总生存期（OS）和无进展生存期（PFS）。
西妥昔单抗组和帕尼单抗组在OS、PFS和缓解率（RR）方面无显著差异（OS：HR = 0.91，95%CI = 0.81 - 1.03，P = 0.14；PFS：HR = 0.92，95%CI = 0.83 - 1.02，P = 0.11；RR：OR = 1.22，95%CI = 0.96 - 1.61，P = 0.14）。我们也未观察到两组在痤疮样皮疹、重度痤疮样皮疹、腹泻和重度腹泻的发生率上有任何统计学差异（痤疮样皮疹：OR = 1.09，95%CI = 0.84 - 1.42，P = 0.51；重度痤疮样皮疹：OR = 1.50，95%CI = 0.80 - 2.81，P = 0.21；腹泻：OR = 1.08，95%CI = 0.82 - 1.42，P = 0.58；重度腹泻：OR = 0.90，95%CI = 0.44 - 1.84，P = 0.77）。帕尼单抗组甲沟炎的发生率降低，而西妥昔单抗组低镁血症和重度低镁血症的发生率降低。（甲沟炎：OR = 0.74，95%CI = 0.55 - 1.00，P = 0.05；低镁血症：OR = 1.85，95%CI = 1.41 - 2.41，P < 0.00001；重度低镁血症：OR = 2.66，95%CI = 1.52 - 4.67，P = 0.0006）。
西妥昔单抗组和帕尼单抗组在治疗mCRC的OS、PFS和RR方面无显著差异。对于不良反应，帕尼单抗组甲沟炎的发生率降低，西妥昔单抗组低镁血症的发生率降低。
