Potentially Resectable mCRC-treated with Cetuximab Combined with Chemotherapy

Surgical resection of a potentially resectable metastatic colorectal cancer (mCRC) may lead to additional clinical benefits for the patients. In some cases, patients with initially unresectable lesions can be converted to resectable ones after induction of chemotherapy; and these patients are primarily treated with fluorouracil-based systemic chemotherapy preoperatively. However, the optimal protocol for neoadjuvant therapy has not been determined yet, and it remains a source of controversy about whether systemic chemotherapy combined with cetuximab can increase the surgical resection rate and obtain more clinical benefits. Metastatic CRC patients that received chemotherapy combined with cetuximab were compared with those undergoing chemotherapy alone. The hazard ratio (HR) and odds ratio (OR) were used as the efficacy indicators. The 95% confidence interval (95% CI) was used as interval estimation method. Seven studies including 1,895 patients were selected. Compared with patients undergoing chemotherapy, the patients receiving systemic chemotherapy combined with cetuximab of the R0 resection was not improved (OR=1.25; 95% CI, 0.76-2.06; p=0.08); The progression-free survival (PFS) of the patients received chemotherapy combined with cetuximab was slightly longer than those received chemotherapy alone (HR=0.88; 95% CI, 0.77-1; p=0.005); and the overall survival (OS) of patients undergoing systemic chemotherapy combined with cetuximab was not prolonged relative to that in patients receiving chemotherapy alone (HR=0.98; 95% CI, 0.86-1.11; p=0.04). Compared with patients receiving chemotherapy alone, the surgical resection rate and PFS are not increased in patients undergoing chemotherapy combined with cetuximab, but the OS is slightly prolonged. Key Words: Chemotherapy, Cetuximab, Colorectal cancer, Metastatic tumor, Surgery.