Treatment Protocols in the Efficacy and Safety of Anti-EGFR Medicines in Combination with Standard Therapy for Patients with Nasopharyngeal Cancer: A Meta-Analysis

Abstract

Objective. This study was conducted to compare the efficacy of standard therapy (radiotherapy/RT/CT) with that of antiepidermal growth factor receptor (anti-EGFR) monoclonal antibody (NPC) therapy in patients with advanced nasopharyngeal cancer. Methods. A meta-analysis was performed to meet the objective of this study. The English databases PubMed, Cochrane Library, and Web of Science were searched. The literature review compared anti-EGFR-targeted therapy with conventional therapy practices. The main outcome measure was overall survival (OS). Secondary goals were progression-free survival (PFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and adverse events (grade 3). Results. The database search resulted in 11 studies, with a total of 4219 participants. It was found that combining an anti-EGFR regimen with conventional therapy did not enhance OS ( $\text{hazard}\text{ratio}\left[\text{HR}\right]=1.18$ ; $95\%\text{confidence}\text{interval}\left[\text{CI}\right]=0.51–2.40$ ; $p=0.70$ ) or PFS appreciably ( $\text{HR}=0.95$ ; $95\%\text{CI}=0.51–1.48$ ; $p=0.88$ ) in patients with nasopharyngeal carcinoma. While LRRFS increased considerably ( $\text{HR}=0.70$ ; $95\%\text{CI}=0.67–1.00$ ; $p=0.01$ ), the combined regimen did not improve DMFS ( $\text{HR}=0.86$ ; $95\%\text{CI}=0.61–1.12$ ; $p=0.36$ ). Treatment-related adverse events included haematological toxicity ( $\text{RR}=0.2$ ; $95\%\text{CI}=0.08–0.45$ ; $p=0.01$ ), cutaneous reactions ( $\text{RR}=7.05$ ; $95\%\text{CI}=2.15–23.09$ ; $p=0.01$ ), and mucositis ( $\text{RR}=1.96$ ; $95\%\text{CI}=1.58–2.09$ ; $p=0.01$ ). Conclusions. Individuals who have nasopharyngeal cancer do not have an increased chance of surviving until a local recurrence of their disease if they get normal therapy in addition to an anti-EGFR regimen. However, this combination does not enhance overall survival. On the other hand, this factor adds to an increase in the number of adverse effects.