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Impact of Anti-EGFR Therapies on HER2-Positive Metastatic Colorectal Cancer: A Systematic Literature Review and Meta-Analysis of Clinical Outcomes.
Bekaii-Saab, Tanios S; Lach, Krzysztof; Hsu, Ling-I; Siadak, Muriel; Stecher, Mike; Ward, James; Beckerman, Rachel; Strickler, John H.
Afiliação
  • Bekaii-Saab TS; Division of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA.
  • Lach K; Maple Health Group, LLC, New York, NY, USA.
  • Hsu LI; Seagen Inc., Bothell, WA, USA.
  • Siadak M; Seagen Inc., Bothell, WA, USA.
  • Stecher M; Seagen Inc., Bothell, WA, USA.
  • Ward J; Seagen Inc., Bothell, WA, USA.
  • Beckerman R; Maple Health Group, LLC, New York, NY, USA.
  • Strickler JH; Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA.
Oncologist ; 28(10): 885-893, 2023 10 03.
Article em En | MEDLINE | ID: mdl-37463037
BACKGROUND: HER2 overexpression/amplification in patients with RAS wild-type (WT) metastatic colorectal cancer (mCRC) may be associated with resistance to standard-of-care anti-EGFR therapies. Given the lack of comprehensive investigations into this association, we assessed the prognostic or predictive effect of HER2 amplification/overexpression on anti-EGFR treatment outcomes. METHODS: A systematic review of MEDLINE, Embase, and Cochrane Library (2001-2021) identified studies evaluating progression-free survival (PFS), overall response rate (ORR), and overall survival (OS) in HER2-positive vs. HER2-negative patients with RAS WT mCRC who received anti-EGFR treatments and whose HER2 status was known. Meta-analyses of proportions (ORR) and hazard ratios (PFS, OS) were performed using random-effect models with pre-specified sensitivity analyses. RESULTS: Five high-quality retrospective cohort studies were included in the meta-analyses representing 594 patients with mCRC. All patients received anti-EGFR treatment, either as monotherapy or in combination with chemotherapy. Meta-analysis of PFS demonstrated a 2.84-fold higher risk of death or progression (95% CI, 1.44-5.60) in patients with HER2-positive (vs. HER2-negative) RAS WT mCRC treated with anti-EGFR regimens. The odds of response to anti-EGFR treatment were 2-fold higher in HER2-negative vs. HER2-positive (odds ratio, 1.96 [95% CI, 1.10-3.48]). Differences in OS were not statistically significant. Sensitivity analyses confirmed the robustness of the base-case estimates. CONCLUSIONS: While this study could not account for all confounding factors, in patients with RAS WT mCRC who received anti-EGFR therapy, HER2 overexpression/amplification was associated with worse PFS and ORR and may therefore predict poorer outcomes. HER2 testing is important to inform treatment decisions and could optimize outcomes for patients.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Neoplasias Colorretais / Neoplasias do Colo Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Neoplasias Colorretais / Neoplasias do Colo Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article