The efficacy and safety of panitumumab in the treatment of patients with metastatic colorectal cancer: a meta-analysis from five randomized controlled trials

Abstract

Ruo-feng Liang,1 Lei-lei Zheng2 1General Department, University Hospital, Affiliated to Zhejiang Science-Technology University, Hangzhou, People’s Republic of China; 2Department of Psychiatry, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China Background: The efficacy of adding panitumumab to chemotherapy remains controversial in the treatment of metastatic colorectal cancer (mCRC). Thus, we conducted this meta-analysis to assess the efficacy and safety of this combination regimen in patients with mCRC.Methods: The PubMed, Embase, and Web of Science databases were comprehensively searched. Eligible studies included randomized controlled trials (RCTs) that estimated the efficacy of panitumumab with or without chemotherapy in the treatment of patients with mCRC. Hazard ratio (HR), risk ratio (RR), and 95% confidence intervals (CIs) were calculated, and heterogeneity was tested using I2 statistics.Results: Four studies involving a total of 3,066 patients were included in this meta-analysis. The addition of panitumumab to chemotherapy significantly improved progression-free survival (PFS) (HR =0.84, 95% CI =0.78–0.91, P=0.000) and the objective response rate (ORR) (RR =2.18, 95% CI =1.13–4.22, P=0.021) compared to chemotherapy alone, but no effect was noted on overall survival (OS) (HR =0.97, 95% CI =0.89–1.05, P=0.402). Subgroup analysis based on KRAS gene status revealed that the combined therapy significantly improved PFS (HR =0.71, 95% CI =0.57–0.88, P=0.002) and ORR (RR =2.43, 95% CI =1.21–4.90, P=0.013) in patients with wild-type KRAS tumors. Irinotecan-based chemotherapy plus panitumumab significantly prolonged PFS in patients with mCRC (HR =0.84, 95% CI =0.76–0.94, P=0.002). The combined treatment also increased the incidence of grade 3/4 adverse events.Conclusion: This meta-analysis indicates that the combination of panitumumab and chemotherapy effectively improved PFS and ORR, but it did not prolong OS. However, as the number of studies in the meta-analysis was limited, more large-scale, better-designed RCTs are needed to assess the combination of panitumumab and chemotherapy. Keywords: panitumumab, chemotherapy, metastatic colorectal cancer, meta-analysis