Meta-analysis of Cetuximab plus Chemotherapy Confirms Benefit in NSCLC

A meta-analysis of four phase II and III trials confirmed the benefit found for cetuximab added to platinum-based chemotherapy in the first-line treatment of advanced non-small cell lung cancer (NSCLC). The findings were reported at the ECCO 15 - ESMO 34 Joint Congress by Jean-Louis Pujol, MD, of Montpellier Academic Hospital, Montpellier, France.

A meta-analysis of four phase II and III trials confirmed the benefit found for cetuximab added to platinum-based chemotherapy in the first-line treatment of advanced non-small cell lung cancer (NSCLC). The findings were reported at the ECCO 15 - ESMO 34 Joint Congress by Jean-Louis Pujol, MD, of Montpellier Academic Hospital, Montpellier, France.

Data from 2018 patients enrolled in four randomized controlled phase II and III trials were analyzed for outcomes to assess the robustness of the individual studies’ findings. Trials included FLEX (Lancet 2009), BMS 100 (J Clin Oncol 2007), BMS 099 (J Thorac Oncol 2008), and LUCAS (Ann Oncol 2008).

The main analyses were adjusted for study and baseline covariates of age, sex, histology, tumor stage, and performance status. The meta-analysis demonstrated a significant benefit across all efficacy endpoints for patients receiving cetuximab in addition to a platinum-based doublet chemotherapy compared with chemotherapy alone, Dr Pujol reported. Risk of death was reduced by 13% with the addition of cetuximab (P < .010). One-year survival was 40.0% with chemotherapy alone, improving to 44.8% with the addition of cetuximab (P = .031). An analysis of the Caucasian subset showed mortality to be reduced by 16% (P <.001). One-year survival was 37.1% without cetuximab versus 43.1% when cetuximab was added to the regimen (P = .012).

“Cetuximab is the first targeted therapy to increase survival in combination with chemotherapy in trials that include all histological subgroups, and the benefit is especially pronounced in Caucasians,” Dr Pujol noted. Risk of progression was reduced by 11% (P = .036), and objective response rate was improved by 46% by the addition of cetuximab (P <.001). “Patients receiving cetuximab had almost a 50% chance of responding to this treatment,” concluded Dr Pujol.

Disclosure: This study was funded by Merck.

ECCO/ESMO Abstract O-9000