Relationship between Efficacy of Cetuximab and Skin Rashes: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHANGXiu-bao ¹ , XIANGRong-wu ¹ , ZHAOQing-chun ² , ZHANGJing-hai ¹ , HANJia-rong ¹ , YANGJing-yu ¹ , XIEMin-xiang ¹ ,  ZHAOMing-yi ¹

1. School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, China;
2. Department of Pharmacy, General Hospital of Shenyang Military Region, Shenyang 110840, China;

Corresponding author：

ZHAOMing-yi, Email: zmy_dl@126.com

Keywords：

Cetuximab; Skin rash; Efficacy; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20150032

Video：

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Objective To systematically review the relationship between skin rashes and efficacy of cetuximab. Methods Such databases as PubMed, EMbase, The Cochrane Library (Issue 1, 2013), CBM, CNKI and VIP were systemically searched to collect literature on relationship between the severity of skin rashes and efficacy of cetuximab published up to Aug. 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and evaluated methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. Results A total of 32 studies involving 1 543 patients were included. The results of metaanalysis showed that:the efficacy of cetuximab in patients with skin rashes was significantly superior to patients without skin rashes (RR=1.53, 95%CI 1.23 to 1.91, P=0.000 2); in addition, the efficacy of cetuximab in patients with severe skin rashes was significantly superior to patients with mild skin rashes (RR=2.42, 95%CI 1.89 to 3.11, P<0.000 01). Conclusion Skin rashes are significantly associated with better efficacy of cetuximab.

Citation： ZHANGXiu-bao, XIANGRong-wu, ZHAOQing-chun, ZHANGJing-hai, HANJia-rong, YANGJing-yu, XIEMin-xiang, ZHAOMing-yi. Relationship between Efficacy of Cetuximab and Skin Rashes: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(2): 181-187. doi: 10.7507/1672-2531.20150032 Copy

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2.	虞永峰, 陆舜. 表皮生长因子受体和血管内皮细胞生长因子受体之外肺癌靶向治疗新进展, 肿瘤, 2010, 30(8):706-710.
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4.	Cunningham D, Humblet Y, Siena S, et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Enl J Med, 2004, 351(4), 337-345.
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6.	van Cutsem E, Lang ID, Haens G. et al. KRAS status and efficacy in the first-line treatment of patients with metastatic colorectal cancer(mCRC)treated with FOLFIR1 with or without cetuximab:The CRYSTAL experience. J Clin Oneol, 2008, 26(20 Supp1):a2.
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24.	叶煌阳, 张映红, 陈建清. 西妥昔单抗联合化疗在晚期结直肠癌一线治疗中的疗效观察. 中国癌症杂志, 2008, l8(9):704-706.
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1. 缪建华, 钟皎, 过雪丹, 等. 西妥昔单抗联合GP方案治疗晚期非小细胞肺癌临床观察. 实用临床医药杂志, 2012, 16(3):90-92.
2. 虞永峰, 陆舜. 表皮生长因子受体和血管内皮细胞生长因子受体之外肺癌靶向治疗新进展, 肿瘤, 2010, 30(8):706-710.
3. Tandon R, Kapoor S, Vali S, et al. Dual epidermal growth factor receptor (EGFR)/insulin-like growth factor-1 receptor (IGF-1R) inhibitor:a novel approach for overcoming resistance in anticancer treatment. Eur J Pharmacol, 2011, 667(1-3):56-65.
4. Cunningham D, Humblet Y, Siena S, et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Enl J Med, 2004, 351(4), 337-345.
5. Petrelli F, Borgonovo K, Cabiddu M, et al. Relationship between skin rash and outcome in non-small-cell lung cancer patients treated with anti-EGFR tyrosine kinase inhibitors:a literature-based metaanalysis of 24 trials. Lung Cancer, 2012, 78(1):8-15.
6. van Cutsem E, Lang ID, Haens G. et al. KRAS status and efficacy in the first-line treatment of patients with metastatic colorectal cancer(mCRC)treated with FOLFIR1 with or without cetuximab:The CRYSTAL experience. J Clin Oneol, 2008, 26(20 Supp1):a2.
7. 陈耀龙, 蔡羽嘉, 王梦书. 循证医学术语介绍Ⅱ. 中国循证医学杂志, 2009, 9(2):143-146.
8. 张天嵩, 钟文昭. 实用循证医学方法学. 中南大学出版社, 2012, 7.
9. 艾昌林, 段玉蓉, Phil Wiffen, 等. 系统评价员选择中文生物医学期刊数据库的策略研究. 中国循证医学杂志, 2010, 10(6):749-753.
10. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration, 2011. Available at:http://www.cochrane-handbook.org.
11. Newcastle-Ottawa量表. 张天嵩, 钟文昭, 主编. 实用循证医学方法学. 第1版. 长沙:中南大学出版社, 2012:63-64.
12. 文进, 李幼平. Meta分析中效应尺度指标的选择. 中国循证医学杂志, 2007, 7(8):606-613.
13. Boccia S, De Feo E, Galli P, et al. A systematic review evaluating the methodological aspects of meta-analyses of genetic association studies in cancer research. Eur J Epidemiol, 2010, 25(11):765-775.
14. 王丹, 翟俊霞, 牟振云, 等. Meta分析中的异质性及其处理方法. 中国循证医学杂志, 2009, 9(10):1115-1118.
15. Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med, 1997, 127(9):820-826.
16. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst, 1959, 22(4):719-748.
17. 魏丽娟, 董惠娟. Meta分析中异质性的识别与处理. 第二军医大学学报, 2006, 27(4):449-450.
18. Gray R, Bhattacharya S, Bowden C, et al. Independent review of E2100:a phase Ⅲ trial of bevacizumab plus paclitaxel versus paclitaxel in women with metastatic breast cancer. J Clin Oncol, 2009, 27(30):4966-4972.
19. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials, 1986, 7(3):177-188.
20. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4):1088-1101.
21. Susman E. Rash correlates with tumour response after cetuximab. Lancet Oncol, 2004, 5(11):647-647.
22. Koo DH, Lee JL, Kim TW, et al. A Phase Ⅱ Study of Cetuximab (Erbitux^®) plus FOLFIRI for Irinotecan and Oxaliplatin-refractory Metastatic Colorectal Cancer. J Korean Med Sci, 2007, 22(Suppl):S98-S103.
23. Pinto C, di Fabio F, Siena S, et al. Phase Ⅱ study of cetuximab in combination with FOLFIRI in patients with untreated advanced gastric or gastroesophageal junction adenocarcinoma (FOLCETUX study). Ann Oncol, 2007, 18(3):510-517.
24. 叶煌阳, 张映红, 陈建清. 西妥昔单抗联合化疗在晚期结直肠癌一线治疗中的疗效观察. 中国癌症杂志, 2008, l8(9):704-706.
25. 应杰儿, 刘碧霞, 钟海均. 转移性结直肠癌西妥昔单抗治疗的疗效及安全性. 肿瘤学杂志, 2012, 18(5):345-348.
26. Lu Z, Zhang X, Shen L, et al. Retrospective study of cetuximab in combination with chemotherapy for patients with colorectal cancer. The Chinese-German Journal of Clinical Oncology, 2008, 7(7):400-403.
27. Racca P, Fanchini L, Caliendo V, et al. Efficacy and skin toxicity management with cetuximab in metastatic colorectal cancer:outcomes from an oncologic/dermatologic cooperation. Clin Colorectal Canc, 2008, 7(1), 48-54.
28. Secord AA, Blessing JA, Armstrong DK, et al. Phase Ⅱ trial of cetuximab and carboplatin in relapsed platinum-sensitive ovarian cancer and evaluation of epidermal growth factor receptor expression:a Gynecologic Oncology Group study. Gynecol Oncol, 2008, 108(3):493-499.
29. 张小田, 沈琳, 张晓东. 西妥昔单抗联合化疗在消化系统肿瘤中的临床应用. 中华肿瘤杂志, 2008, 30(5):385-389.
30. 金璿, 白羽, 于晶琳. 西妥昔单抗联合化疗治疗转移性结直肠癌的临床观察. 肿瘤基础与临床, 2008, 21(4):286-290.
31. 张伟锋, 刘连科, 刘怡茜. 西妥昔单抗联合化疗治疗消化系统肿瘤的临床研究. 中国现代药物应用, 2008, 2(24):18-22.
32. 王琳, 秦叔逵, 钱军. 西妥昔单抗联合化疗治疗晚期结直肠癌的临床观察. 临床肿瘤学杂志, 2009, 14(7):628-632.
33. Lorenzen S, Schuster T, Porschen R, et al. Cetuximab plus cisplatin-5-fluorouracil versus cisplatin-5-fluorouracil alone in first-line metastatic squamous cell carcinoma of the esophagus:a randomized phase Ⅱ study of the Arbeitsgemeinschaft Internistische Onkologie. Ann Oncol, 2009, 20(10):1667-1673.
34. Klinghammer K, Knödler M, Schmittel A, et al. Association of epidermal growth factor receptor polymorphism, skin toxicity, and outcome in patients with squamous cell carcinoma of the head and neck receiving cetuximab-docetaxel treatment. Clin Cancer Res, 2010, 16(1):304-310.
35. Kullmann F, Hollerbach S, Dollinger MM. et al. Cetuximab plus gemcitabine/oxaliplatin (GEMOXCET) in first-line metastatic pancreatic cancer:a multicentre phase Ⅱ study. Br J Cancer, 100(7):1032-1036.
36. 林榕波, 郭增清, 陈奕贵. 西妥昔单抗联合伊立替康治疗化疗耐药晚期结直肠癌. 中国癌症杂志, 2008, 18(1):79-80.
37. 赵波涛. 西妥昔单抗联合FOLFIRI方案治疗化疗耐药晚期结直肠癌临床疗效观察. 江西医药, 2010, 45(4):337-339.
38. 白利平, 刘忠臣, 齐忠权. 西妥昔单抗联合化疗初始治疗22例转移性结直肠癌的近期疗效观察. 中国肿瘤临床, 2010, 34(4):220-224.
39. 王风云, 张艳桥, 张纯惠. 西妥昔单抗联合化疗在治疗大肠癌肝转移中的疗效观察. 哈尔滨医科大学学报, 2010, 44(1):77-81.
40. 李敏, 方明治, 钱垠. 西妥昔单抗联合伊立替康为主方案治疗转移性结直肠癌. 肿瘤防治研究, 2010, 37(8):938-941.
41. 丘惠娟, 夏良平, 徐瑞华. 含Cetuximab方案治疗10例胃癌或食管癌的近期疗效分析. 肿瘤学杂志, 2010, 16(4):294-297.
42. Dahan L, Norguet E, Etienne-Grimaldi MC, et al. Pharmacogenetic profiling and cetuximab outcome in patients with advanced colorectal cancer. BMC cancer, 2011, 11(1):496-507.
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Chinese Journal of Evidence-Based Medicine

Relationship between Efficacy of Cetuximab and Skin Rashes: A Systematic Review

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