Infectious complications in cancer patients treated with anti-EGFR monoclonal antibodies cetuximab and panitumumab: A systematic review and meta-analysis

Funakoshi, Tomohiro; Suzuki, Maya; Tamura, Kazuo

doi:10.1016/j.ctrv.2014.09.002

Cited by 28 publications

(17 citation statements)

References 48 publications

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“…Rafailidis et al [42] conducted the first systematic review in 2007 and demonstrated that there was an increased risk of developing monoclonal antibodies related severe infections but not for fatal adverse events. In consistent with previous results, two later meta-analyses also showed that EGFR-monoclonal antibodies significantly increased the risk of developing severe infections but not for fatal adverse events [16, 43]. Recently, Qi et al performed another meta-analysis and showed that there was an increased risk of developing all-grade (RR 1.45, p < 0.001) and high-grade (RR 1.59, p < 0.001) infectious events in cancer patients treated with bevacizumab [44].…”

Section: Discussionsupporting

confidence: 89%

Incidence and risk of infections associated with EGFR-TKIs in advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Wang

et al. 2017

Oncotarget

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Currently, the overall incidence and risk of infections with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) in non-small-cell lung cancer (NSCLC) patients remained undetermined. We searched Pubmed for related articles published from 1 January 1990 to 31 November 2015. Eligible studies included prospective randomized controlled trials (RCTs) evaluating therapy with or without EGFR-TKIs in patients with NSCLC. Data on infections were extracted. Pooled incidence, Peto odds ratio (Peto OR), and 95% confidence intervals (CIs) were calculated. A total of 17,420 patients from 25 RCTs were included. The use of EGFR-TKIs significantly increased the risk of developing all-grade infections (Peto OR 1.48, 95%CI: 1.12-1.96, p = 0.006) in NSCLC patients, but not for severe (Peto OR 1.26, 95%CI: 0.96-1.67, p = 0.098) and fatal infections (Peto OR 0.81, 95%CI: 0.43-1.53, p = 0.52). Meta-regression indicated the risk of infections tended to increase with the treatment duration of EGFR-TKIs. No publication of bias was detected. In conclusion, the use of EGFR-TKIs significantly increased the risk of developing all-grade infectious events in NSCLC patients, but not for severe and fatal infections. Clinicians should be aware of the risks of infections with the administration of these drugs in these patients.

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Section: Discussionsupporting

confidence: 89%

Incidence and risk of infections associated with EGFR-TKIs in advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Wang

et al. 2017

Oncotarget

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“…In a meta-analysis, it was shown that both drugs were related to a significantly increased risk of grade 3–4 infections, but only cetuximab was associated with a higher incidence of febrile neutropenia [91]. In this analysis, studies where anti-EGFR mAbs were used for indications other than mCRC, were also included.…”

Section: Discussionmentioning

confidence: 99%

Clinical Pharmacokinetics and Pharmacodynamics of the Epidermal Growth Factor Receptor Inhibitor Panitumumab in the Treatment of Colorectal Cancer

et al. 2017

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Despite progress in the treatment of metastatic colorectal cancer (mCRC) in the last 15 years, it is still a condition with a relatively low 5-year survival rate. Panitumumab, a fully human monoclonal antibody directed against the epidermal growth factor receptor (EGFR), is able to prolong survival in patients with mCRC. Panitumumab is used in different lines of therapy in combination with chemotherapy, and as monotherapy for the treatment of wild-type (WT) RAS mCRC. It is administered as an intravenous infusion of 6 mg/kg every 2 weeks and has a t ½ of approximately 7.5 days. Elimination takes place via two different mechanisms, and immunogenicity rates are low. Only RAS mutations have been confirmed as a negative predictor of efficacy with anti-EGFR antibodies. Panitumumab is generally well tolerated and has a manageable toxicity profile, despite a very high prevalence of dermatologic side effects. This article presents an overview of the clinical pharmacokinetics and pharmacodynamics of panitumumab, including a description of the studies that led to its approval in the different lines of therapy of mCRC.

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“…A previous meta-analysis conducted by Kaymakcalan et al [65] demonstrated that treatment with mTOR inhibitors was associated with a significant increase in the risk of developing infections. More recently, two meta-analyses also found that the use of anti-EGFR monoclonal antibodies (cetuximab and panitumumab) was associated with a significantly higher risk of developing high-grade infections and febrile neutropenia [66,67]. However, the incidence and risk of infections with bevacizumab remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Bevacizumab increases the risk of infections in cancer patients: A systematic review and pooled analysis of 41 randomized controlled trials

Zhang

et al. 2015

Critical Reviews in Oncology/Hematology

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Infectious complications in cancer patients treated with anti-EGFR monoclonal antibodies cetuximab and panitumumab: A systematic review and meta-analysis

Cited by 28 publications

References 48 publications

Incidence and risk of infections associated with EGFR-TKIs in advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Incidence and risk of infections associated with EGFR-TKIs in advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Clinical Pharmacokinetics and Pharmacodynamics of the Epidermal Growth Factor Receptor Inhibitor Panitumumab in the Treatment of Colorectal Cancer

Bevacizumab increases the risk of infections in cancer patients: A systematic review and pooled analysis of 41 randomized controlled trials

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