[Anti-EGFR monoclonal antibodies in recurrent and/or metastatic head and neck squamous cell carcinoma: a meta-analysis].

Objective: To systematically review the literature regarding the effectiveness and adverse reaction of epidermal growth factor receptor-monoclonal antibodies (RGFR-mAbs) in improving the prognosis of R/M HNSCC so as to develop evidence-based recommendations for treatment.
Methods: Comprehensively searches were performed for the databases of CBM, PubMed, Embase and Cochrane to identify the published studies on the effect of RGFR-mAbs in recurrent and/or metastatic head and neck squamous carcinoma (R/M HNSCC) patients. Primary outcomes included overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). And secondary outcomes included such severe adverse events (grade III-IV) as neutropenia, anemia, thrombocytopenia, skin reactions, hypokalemia, vomiting and hypomagnesemia, etc.
Results: A meta-analysis was conducted for 5 randomized controlled trials involving a total of 1 615 patients. Pooled data suggested the efficacies of EGFR-mAbs in R/M HNSCC patients. And adding EGFR-mAbs to conventional therapy led to significantly improved efficacies for R/M HNSCC (ORR: RR=1.61, 95% CI: 1.34-1.92, P<0.001; PFS: HR=0.68, 95% CI: 0.61-0.76, P<0.001; OS: HR=0.84, 95% CI: 0.75-0.95, P=0.004). Adverse events were comparable between EGFR-mAbs and control groups, except for increased incidence in skin reactions, hypomagnesemia, anorexia, exsiccosis and thrombogenesis.
Conclusions: Existing randomized controlled trials support the efficacies of EGFR-mAbs for R/M HNSCC. During Mabs therapy, skin reactions and hypomagnesemia should be closely monitored.