Yunhong T, et al. - Researchers, in this study, examined the efficacy and safety of anti-epidermal growth factor receptor (EGFR) agents administered concurrently with standard therapies for head and neck squamous cell carcinoma (HNSCC). As per findings, cetuximab addition to standard therapy may improve outcomes for recurrent or metastatic (R/M) HNSCC patients, while causing a moderate increase in severe adverse events (SAEs, grade ≥ 3). Compared with radiotherapy (RT) alone, anti-EGFR mAb plus RT seemed to have potential for improving overall survival (OS) for stage III/IV patients. However, they observed no improvement in outcomes with replacement of chemotherapy with EGFR mAb or adding EGFR mAb to combined chemotherapy and RT.

Methods

• Researchers included randomized controlled trials that evaluated addition of EGFR targeted therapy vs standard therapy alone.
• Overall survival (OS) was assessed as the primary outcome.
• Progression-free survival (PFS), overall response rate (ORR), locoregional control, and severe adverse events (SAEs, grade ≥ 3) were assessed as secondary outcomes.

Results

• Researchers included 16 eligible trials with 4,031 patients.
• A significant improvement in OS of patients with HNSCC was observed with the addition of anti-EGFR regimens to standard therapy (HR = 0.89; 95% CI, 0.82–0.96), with a moderately elevated rate of SAEs (RR = 1.08; 95% CI, 1.03–1.13).
• In subgroup analysis, the survival benefit was observed when cetuximab was administered concurrently with radiotherapy (RT) for stage III/IV patients (HR = 0.76; 95% CI, 0.61–0.94; P=0.01), or with chemotherapy for R/M HNSCC (HR = 0.86; 95% CI, 0.78–0.95; P=0.005).
• They observed significantly increased ORR (RR = 1.51; 95% CI 1.05–2.18) and PFS (HR = 0.72; 95% CI, 0.59–0.88) in R/M HNSCC patients treated with anti-EGFR plus chemotherapy, while there appeared no significant improvements in stage III/IV patients treated with anti-EGFR plus standard therapy.