Efficacy of Cetuximab in Nasopharyngeal Carcinoma Patients Receiving Concurrent Cisplatin-Radiotherapy: A Meta-Analysis

Abstract

Background. Nasopharyngeal carcinoma (NPC) is a malignant neoplasm of the nasopharyngeal epithelium. Concurrent chemoradiotherapy has been established as a standard treatment for locoregional NPC, and cisplatin is a common agent in NPC treatment. Cetuximab is a monoclonal antibody against epidermal growth factor receptor. This meta-analysis was performed to evaluate the curative effectiveness and survival outcomes of cetuximab in NPC patients who received concurrent cisplatin-radiotherapy. Methods. PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wan Fang, and China Biology Medicine disc (CBM) were used to search publications studying on concurrent chemoradiotherapy and/or cetuximab in NPC. The qualities of included RCTs were assessed by the Newcastle-Ottawa Scale. STATA 14.0 was used to conduct the statistical analysis. Results. In total, 17 trials with 2066 patients were included in this meta-analysis. The results from this study show that cetuximab improved the therapy efficacy in NPC patients who received concurrent cisplatin-radiotherapy. Cetuximab cotreatment improved the complete response ( $\text{RR}=1.92$ , 95% CI [1.61, 2.30]), and reduced stable disease ( $\text{RR}=0.67$ , 95% CI [0.51, 0.88]) as well as progression disease ( $\text{RR}=0.24$ , 95% CI [0.15, 0.40]). Besides, it also improved the overall survival ( $\text{RR}=1.10$ , 95% CI [1.02, 1.18]), disease-free survival ( $\text{RR}=1.09$ , 95% CI [1.03, 1.15]), metastasis-free survival ( $\text{RR}=1.06$ , 95% CI [1.01, 1.11]), and relapse-free survival ( $\text{RR}=1.04$ , 95% CI [1.01, 1.07]) in NPC patients. Conclusions. Cetuximab could improve the curative efficacy and survival outcomes of NPC patients who underwent concurrent cisplatin-radiotherapy. However, all the trials included were conducted in China; thus, the quality of the trials in this study remains doubtful. More high-quality RCTs should be included in further relevant studies.