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Anti-EGFR Monoclonal Antibodies in Advanced Biliary Tract Cancer: A Systematic Review and Meta-analysis

Alessandro Rizzo1, Giorgio Frega2, Angela Dalia Ricci2

  • 1Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy rizzo.alessandro179@gmail.com.

In Vivo (Athens, Greece)
|March 1, 2020
PubMed
Abstract

Insights

Adding epidermal growth factor receptor (EGFR) targeted therapy to chemotherapy for biliary tract cancer (BTC) does not improve survival. This combination therapy also increases risks of neutropenia, thrombocytopenia, and skin rash in advanced BTC patients.

Area of Science:

  • Oncology
  • Medical Research

Background:

  • Biliary tract cancer (BTC) treatment has advanced, yet first-line chemotherapy (CHT) efficacy remains limited.
  • Epidermal growth factor receptor (EGFR) targeted therapy has not demonstrably improved outcomes when added to standard CHT for BTC.

Purpose of the Study:

  • To evaluate the efficacy and safety of gemcitabine-based first-line CHT combined with EGFR monoclonal antibodies (EGFR-mAbs) in advanced or metastatic BTC.
  • To determine if EGFR-mAbs enhance overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) in BTC patients.

Main Methods:

  • A meta-analysis was conducted on available randomized clinical trials.
  • The analysis focused on gemcitabine-based CHT plus EGFR-mAbs versus gemcitabine-based CHT alone in advanced/metastatic BTC.

Main Results:

  • Pooled hazard ratios for OS and PFS were 0.82 and 0.88, respectively, showing no significant improvement.
  • No significant difference in objective response rate (ORR) was observed between the groups.
  • The addition of EGFR-mAbs significantly increased the risk of grade 3-4 neutropenia, thrombocytopenia, and skin rash.

Conclusions:

  • The combination of EGFR-mAbs with gemcitabine-based first-line CHT does not significantly improve survival or response rates in advanced BTC.
  • This combination therapy is associated with a higher incidence of hematological and cutaneous adverse events.
Keywords:
BTCBiliary tract cancerKRASanti-EGFRcetuximabmeta-analysispanitumumabreview

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