Efficacy And Safety Of Cetuximab Combined With FOLFOX Regimen In The Treatment Of Advanced Colorectal Cancer:a Meta-Analysis

Objective: To evaluate the efficacy and safety of cetuximab combined with FOLFOX in the treatment of advanced colorectal cancer.Methods: Searching PubMed,Cochrane Library,Embase,CBM,Web of Science,CNKI,and WANFANG data by computer.The time limit for searching was until the database was built until November 2017.All the retrieved records are kept with the title,author,source,summary,DOL,etc.,In case of finding out the full text.Based on inclusion criteria and exclusion criteria,Inclusion of eligible documents in this meta analysis of this paper and the data is sorted out,and calculated by Review manager version5.2.If the value of P is less than 0.05,the statistical significance is considered.Results: This study included 10 clinical trials,all of them were RCTs studies,and 5747 subjects were included in this study.Among them,2876 patients in cetuximab combined with FOLFOX group,2871 patients in FOLFOX group.Meta-analysis results: the total response rate of disease was analyzed.It can be seen that cetuximab combined with FOLFOX group(44.28%)was significantly different from that of FOLFOX group(32.09%),but for KRAS wild type,the combined group(54.03%)was more effective than the simple group(39.20%).The remission rate of wild-type patients with KRAS was higher than that with cetuximab combined with FOLFOX.For patients without KRAS gene test,cetuximab combined with FOLFOX could not improve PFS(HR=0.79,95%CI:0.61-1.01,P=0.06)and OS(HR=1.04,95%CI:0.91-1.18,P=0.58).For KRAS wild-type patients.The combination of cetuximab and FOLFOX can improve the patient's PFS(HR=0.68,95%CI:0.47-1.00,P=0.05),and has no effect on the patient's OS(HR=0.90,95%CI:0.63-1.30,P=0.58).In terms of safety,The incidence of rashes in the cetuximab combined with FOLFOX group was 23.13% and that in the FOLFOX group without cetuximab was 2.61%.The difference between the two groups was statistically significant(P<0.00001).It can be seen that cetuximab can increase the incidence of skin rash in patients;in the gastrointestinal reactions,there was no significant difference between the two groups(P=0.58).Conclusion: 1.Cetuximab combined with FOLFOX can improve the disease response rate of patients with advanced colorectal cancer,especially the disease response rate of patients with KRAS wild type,2.Cetuximab plus FOLFOX can improve progression-free survival in patients with KRAS wild-type colorectal cancer,but it does not improve overall survival,3.In terms of safety,cetuximab can increase the incidence of rash in patients with advanced colorectal cancer.