mCRC: adding erlotinib to bevacizumab prolongs PFS, OS

  • Kaveh S & al.
  • Int J Clin Pharm
  • 4 Jan 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Results of a meta-analysis suggest that adding erlotinib to bevacizumab prolong PFS and OS in patients with metastatic colorectal cancer (mCRC).

Why this matters

  • The 2 drugs would be expected to have a synergistic effect because they target the EGFR and VEGF pathways, but 2 of the 3 included studies had shown a nonsignificant survival benefit for the combination.

Study design

  • Meta-analysis of 3 trials (n=682).
  • Funding: Iran University of Medical Sciences.

Key results

  • Based on a fixed-effect model, the combination had a positive effect on survival compared with bevacizumab alone: risk ratio (RR), 0.78 (95% CI, 0.66-0.93).
  • A fixed-effect model showed that the combination improved PFS: RR, 0.81 (95% CI, 0.7-0.93).
  • There was no significant difference between the 2 groups with respect to asthenia (combination RR, 3.6; 95% CI, 0.9-14.40) or hypertension, hand-foot syndrome, proteinuria, nausea, or vomiting.
  • The combination was associated with a higher frequency of rash (RR, 22.652; 95% CI, 5.528-92.824) and diarrhea (RR, 8.956; 95% CI, 2.74-29.270).

Limitations

  • Included only 3 studies, all of which were open-label.

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