CETUXIMAB IN THE TREATMENT OF MCRC LIVER LIMITED DISEASE- A SYSTEMATIC REVIEW
Author(s)
Correa Jd1, Amaral LM2, Biglia LV3, Souza PV3, Blum RR3
1SENSE Company, Rio de Janeiro, Brazil, 2Sense Company, Rio de Janeiro, Brazil, 3Merck, São Paulo, Brazil
OBJECTIVES:: Colorectal cancer (CRC) was the third most diagnosed type of cancer in men and the second in women. As treatment options, there are drug therapy, surgery and radiotherapy. In liver-limited disease, cetuximab and chemotherapy can cause early tumor reduction. Patients who have a total resection of the metastases present better prognosis. This study aims to assess efficacy and safety of cetuximab plus FOLFIRI/FOLFOX as conversion therapy for RAS wild type (wt) patients with mCRC, liver-limited disease. METHODS:: A systematic review was conducted until December 2016 through Cochrane Central Register of Controlled Trials, The Cochrane Library, MEDLINE, LILACS and CRD. Two investigators independently selected and reviewed meta-analyzes, systematic reviews, clinical trials and economic evaluations involving patients with RASwt mCRC with liver-limited disease in the first-line treatment with cetuximab. RESULTS:: Three studies met the eligibility criteria. All of them reported that patients treated with cetuximab + chemo presented greater benefit in terms of overall survival (OS) (29.5 vs. 22.2 months, p=0,02) and in terms of progression free survival (PFS) (13.4 vs. 7 months, p=0,034) compared to chemo alone. Conversion rates for resection of hepatic metastases were 40% vs. 19.2% for the cetuximab + chemo group. Among the patients who achieved resection, the median time to progression was 14.1 months (CI 95%:1.3-30.8 months). CONCLUSIONS:: The three articles included in this systematic review provide additional evidence indicating that the use of cetuximab with cytotoxic chemotherapy FOLFIRI or FOLFOX causes early tumor reduction, being a potent predictor of survival outcomes in patients with RASwt mCRC with liver-limited disease.
Conference/Value in Health Info
2017-09, ISPOR Latin America 2017, Sao Paulo, Brazil
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN7
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Oncology